Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Backho Kim, PHYSICALTHERAPY

Individual provider Acupuncturist · NPI 1942867874

Backho Kim, PHYSICALTHERAPY is a Physical Therapist in Private Practice in Woodside, New York. Qualified in 2017, 9 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

6019 Roosevelt Ave Ste 221
Woodside, NY 11377-4375
Phone: (929) 232-5758
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 038794 (NY)
Acupuncturist Taxonomy 171100000X · Licence 007243 (NY)

Record details

NPI number1942867874
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICALTHERAPY
Sole proprietorYes
NPI enumeratedMay 27, 2019
Last updated in NPPESApril 25, 2026
Certification dateApril 25, 2026
Mailing address6019 Roosevelt Ave Ste 221, Woodside, NY 11377-4375

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Woodside