Jisun Kim, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

15397 Issued in MA

Practice address

2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552

Phone

(646) 780-0926

NPI assigned

Aug 28, 2024

Sex

Female

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

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New York Physical and Occupational Therapy Services, PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1356703631

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1093549438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRE AVE UNIT 758",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 OCEAN AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "646-780-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JISUN",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "15397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenni H Kim
• Jennie Kim, MD
• Jessica Louis Kim, DO
• Jinri Kim
• Jinsoo Kim, D.D.S.
• Jiyeon Kim
• Joo Song Kim, M.D.
• Jooyeon Kim
• Jorge Du Ub Kim, MD
• Joseph Kim, M.D.

• Occupational Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.