Individual provider Active NPI

Wan Ju Ho

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1962252387
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050883 Issued in NY
Practice address
475 Northern Blvd #11
Great Neck, NY 11021
Phone
(516) 829-0030
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 050883 NY Primary

Addresses

Primary practice location

475 Northern Blvd #11
Great Neck, NY 11021

Mailing address

25705 Pembroke Ave
Great Neck, NY 11020-1037
Phone (714) 213-9581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002241 NY Practitioner - Physical Therapist in Private Practice 4981042892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reddy Care Physical Therapy PCGroup PAC ID 5890685986, 139 clinicians

Practice addresses (Care Compare)

475 Northern Blvd
Great Neck, NY 11021-4802
Phone (516) 829-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050883NYMDPsychiatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Apr 2, 2024 Accepting new patients

Locations

1740 Sunrise Hwy
Bay Shore, NY 11706

20832 Cross Island Pkwy
Ste 32
Bayside, NY 11360
Phone (516) 466-7723

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

475 Northern Blvd
Ste 37
Great Neck, NY 11021
Phone (516) 344-0023

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1962252387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25705 PEMBROKE AVE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110201037",
            "telephone_number": "714-213-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD #11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-829-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HO",
        "first_name": "WAN JU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.