JEAGWAN LIM
NPI 1124475363
Physical Therapist in Flushing, NY

Active since May 18, 2016
4199 MAIN ST STE 202B, FLUSHING, NY 11355(929) 398-3120(833) 985-0130 Get Directions Write a Review

NPPES record last updated: April 26, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 26, 2024, Jun 1, 2021, Oct 17, 2019 and 6 more (9 updates tracked since 2016).

About Jeagwan Lim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEAGWAN LIM (NPI 1124475363) is an individual physical therapist in Flushing, New York, licensed in New York (035534) and active in the NPI registry since May 2016.

NPPES Registry Identity

NPI1124475363
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameJEAGWAN LIM
Location Address4199 MAIN ST STE 202BFlushing, NY 11355-3821
Mailing Address13620 Maple Ave Ste 201cFlushing, NY 11355-5167 · (929) 398-3120 · Fax (833) 985-0130
Fax(833) 985-0130
Sole ProprietorYes
Enumeration DateMay 18, 2016
Last NPPES UpdateApril 26, 20249 updates tracked since enumeration
NPPES CertifiedApril 26, 2024
✔ NPI 1124475363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in NY · 035534
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
4199 MAIN ST STE 202B, Flushing, NY 11355

Other Identifiers 1

Medicaid05027858NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeagwan Lim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Jeagwan Lim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapist
4199 MAIN ST STE 202B
Flushing, NY 11355
  • Reassigned Medicare billing, New York enrollment
  • 2 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
4199 MAIN ST STE 202B
FLUSHING, NY 11355
Physical Therapist
4199 MAIN ST STE 202B
FLUSHING, NY 11355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeagwan Lim's NPI number?

The NPI number for Jeagwan Lim is 1124475363. It was assigned to this individual provider in the NPPES registry on May 18, 2016.

Where is Jeagwan Lim located?

Jeagwan Lim practices at 4199 Main St Ste 202B, Flushing, NY 11355. The listed phone number is (929) 398-3120.

What is Jeagwan Lim's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Jeagwan Lim enrolled in Medicare?

Yes. Jeagwan Lim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeagwan Lim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeagwan Lim reassigns Medicare benefits to Laon Physical Therapy PC (Flushing, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeagwan Lim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeagwan Lim was last updated on April 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.