Changrae Kim, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

006653 Issued in NY

Practice address

6508 Grand Ave
Maspeth, NY 11378-2423

Phone

(917) 359-3937

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4
• Direct secure messaging: ckim2756@direct.medisys.org

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

• Jamaica Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jamaica, NY
  • NPI 1477505220
  Medicare reassignment NPD
• Jamaica Hospital

  • Skilled Nursing Facility
  • Jamaica, NY
  • NPI 1750516795
  NPD
• St John'S Medical Services PC

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1023042173
  NPD
• Steven Mehl, D.P.M., P.C.

  • Foot & Ankle Surgery Podiatrist
  • Maspeth, NY
  • NPI 1154338747
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409443200000",
    "number": "1083022149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BAY CLUB DR APT 5X",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602921",
            "telephone_number": "917-359-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 GRAND AVE",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113782423",
            "telephone_number": "917-359-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHANGRAE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanche Kania, SLP/TSHH
• Allison Karban, RPH
• Colette Kempf, LPN
• Ammar Khan, PHYSICIAN ASSISTANT
• Saadia Khondoker
• Su Ji Kim, RPH
• King Capital Pro Corp
• Hannah Lamar Koelbl, MS, OTR/L
• Jack Kolacz
• Patricia Nadia Kolakowski, M.S. OT

• Foot & Ankle Surgery Podiatrist in Maspeth, NY
• Providers in Maspeth, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2014; 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.