Individual provider Active NPI

Hyunchu Kim-Gold

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1033508551
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339093 Issued in NY
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-2710
NPI assigned
Jan 21, 2015
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ15115100 NJ
Family Nurse Practitioner 363LF0000X 339093 NY Primary
Emergency Registered Nurse 163WE0003X 612489 NY

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

200 Community Dr
Great Neck, NY 11021-5510
Phone (212) 434-2710

Other practice location 1

400 Sylvan Ave Ste 108
Englewood Cliffs, NJ 07632-2717
Phone (201) 408-5314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190129001259 NY Practitioner - Nurse Practitioner 8921325119 Reassigns benefits to 1 organization
I20250107003284 NJ Practitioner - Nurse Practitioner 8921325119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

27005 76TH Ave
Mhg069
New Hyde Park, NY 11040-1402
Phone (718) 470-7848

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
612489NYMDEmergency Registered Nurse
26NJ15115100NJMDFamily Nurse Practitioner
339093NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 5, 2018 Accepting new patients
Hudson MD Group CurrentSince Oct 21, 2024 Accepting new patients
Functional Nurse Practitioner in Family Health Family Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Dec 5, 2018 Accepting new patients
David W. Lee MD PA PastSince Feb 6, 2007 Accepting new patients

Locations

400 Sylvan Ave
Ste 108
Englewood Cliffs, NJ 07632
Phone (201) 408-5314

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

13617 39th Ave
Fl 4
Flushing, NY 11354
Phone (718) 559-3600

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

130 E 77th St
Fl 3
New York, NY 10075
Phone (212) 434-3691

2 W 32nd St
Ste 602
New York, NY 10001
Phone (201) 774-8275

378 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-1850

2 Medical Park Dr
Ste 7
West Nyack, NY 10994
Phone (201) 206-2006

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: hkimgold61070@northwell.direct-ci.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1033508551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COMMUNITY DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215510",
            "telephone_number": "212-434-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Sylvan Ave Ste 108",
            "address_purpose": "LOCATION",
            "city": "Englewood Cliffs",
            "state": "NJ",
            "postal_code": "076322717",
            "country_code": "US",
            "telephone_number": "201-408-5314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM-GOLD",
        "first_name": "HYUNCHU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15115100",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339093",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "612489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.