Individual provider Active NPI

Yeongcheol Kim, MD

  • Specialist
  • Flushing, NY
National Provider Identifier
1023050051
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
116914 Issued in NY
Practice address
4355 147TH St
Flushing, NY 11355-1736
Phone
(718) 762-0900
Fax
(718) 886-5659
NPI assigned
Jun 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 116914 NY Primary
Specialist 174400000X 25MA03155400 NJ

Addresses

Primary practice location

4355 147TH St
Flushing, NY 11355-1736

Mailing address

560 S Broadway
Hicksville, NY 11801-5027
Phone (516) 933-2800

Other identifiers 2

IdentifierTypeStateIssuer
10476694OtherNYCAQH
00216371MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03155400NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Past Accepting new patients
Clifton Orthopedic Associates P.a. Past Accepting new patients
Elizabeth Chiropractic & Rehab, PA PastSince Jan 1, 2006 Accepting new patients
Doshi Diagnostic Imaging Services PC PastSince Jan 1, 2012 Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC PastSince Dec 1, 2015 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023050051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S BROADWAY",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015027",
            "telephone_number": "516-933-2800",
            "fax_number": "516-933-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 147TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551736",
            "telephone_number": "718-762-0900",
            "fax_number": "718-886-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEONGCHEOL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "116914",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03155400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10476694",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00216371",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.