Sangjin Lim, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

25MB11870000 Issued in NJ

Practice address

311 Bay Ave Ste 102
Glen Ridge, NJ 07028-1621

Phone

(973) 798-4777

Fax

(973) 680-7857

NPI assigned

Jun 10, 2014

Last updated

May 4, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Sports MedicineAlso: Family Practice

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Crystal Run Healthcare Physicians LLPGroup PAC ID 6901792696, 366 clinicians

MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054
• Helen Hayes Hospital Hospital, West Haverstraw, NY, CCN 330405

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: slim1357837@ahs.direct-ci.com

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.

• MPV New Jersey MD Services PC

  • General Practice Physician
  • Westwood, NJ
  • NPI 1215391271
  Medicare reassignment Care Compare group NPD
• Crystal Run Healthcare Physicians LLP

  • General Practice Physician
  • Middletown, NY
  • NPI 1952376410

  Family Medicine

  Medicare reassignment Care Compare group NPD
• MPV New Jersey MD Services PC

  • Durable Medical Equipment & Medical Supplies
  • Bloomfield, NJ
  • NPI 1801542816

  Family Medicine

  NPD
• Crystal Run Healthcare Physicians LLP

  • Durable Medical Equipment & Medical Supplies
  • Monroe, NY
  • NPI 1558857425
  NPD
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New York, NY
  • NPI 1073472528
  NPD (past)

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

• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation
• State of New York Comptrollers Office

  dba Helen Hayes Hospital

  • General Acute Care Hospital
  • West Haverstraw, NY
  • NPI 1063525442
  Care Compare affiliation

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1063825792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 BAY AVE STE 102",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281621",
            "telephone_number": "973-798-4777",
            "fax_number": "973-680-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 BAY AVE STE 102",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281621",
            "telephone_number": "973-798-4777",
            "fax_number": "973-680-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "SANGJIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NJ",
            "license": "25MB11870000",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MB11870000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yong Min Kwon, M.D.
• Robert Labruzza, D.C.
• Jill D Langell, OTR/L
• Lauren Lawson
• Robert Levai, MD
• Lloyd I. S. Zbar, MD, PA
• London Private LLC (Sun Pharmacy)
• Janet P Mack, RN, MSN, APN-C
• Jill Melinda Magioncalda, MSN, APRN, FNP- BC
• Magnus Imaging, LLC

• Sports Medicine (Family Medicine) Physician in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Sports Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.