Individual provider Active NPI

Annie Juhae Kim, MD

  • Gynecology Physician
  • New York, NY
National Provider Identifier
1023404019
Registry record updated Jun 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
299052 Issued in NY
Practice address
877 Park Ave
New York, NY 10075-0341
Phone
(646) 798-8212
Fax
(212) 904-0980
NPI assigned
Apr 7, 2015
Last updated
Jun 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 299052 NY Primary

Addresses

Primary practice location

877 Park Ave
New York, NY 10075-0341

Mailing address

1 Northside Piers Apt 22H
Brooklyn, NY 11249-3187
Phone (646) 798-8212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190716001265 NY Practitioner - Obstetrics/Gynecology 8820323660 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Jun 21, 2019 Accepting new patients
Openloop Healthcare Partners PC CurrentSince May 24, 2023 Accepting new patients
Ny Pelvic Pain and Minimally Invasive Gynecologic Surgery PC Gynecology PastSince Aug 1, 2022 Accepting new patients

Locations

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

111 E 210th St
Bronx, NY 10467

28 Liberty St
New York, NY 10005
Phone (415) 205-1229

80 Broad St
Fl 5
New York, NY 10004
Phone (201) 286-1122

Interoperability endpoints

  • Direct secure messaging: akim67324@northwell.direct-ci.com
  • Direct secure messaging: annie.kim@964797803397124.direct.elationemr.com

Organizations & group practices 5

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": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1023404019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORTHSIDE PIERS APT 22H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493187",
            "telephone_number": "646-798-8212",
            "fax_number": "212-904-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750341",
            "telephone_number": "646-798-8212",
            "fax_number": "212-904-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANNIE",
        "middle_name": "JUHAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "299052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.