Woo Sup Kim M D P C

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

160493 Issued in NY

Legal business name

WOO SUP KIM M D P C

Practice address

9711 101St Ave
Ozone Park, NY 11416-2523

Phone

(718) 845-6000

NPI assigned

Jan 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Woo Sup Kim, M.DNPI 1982769857

Title

D.R

Phone

(718) 845-6000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Woosup Kim, MD

  • Internal Medicine Physician
  • Ozone Park, NY
  • NPI 1982769857
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330646400000",
    "number": "1104198878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 101ST AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162523",
            "telephone_number": "718-845-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 101ST AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114162523",
            "telephone_number": "718-845-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOO SUP KIM M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-03-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "WOO SUP",
        "authorized_official_title_or_position": "D.R",
        "authorized_official_telephone_number": "718-845-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "160493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• We Believe in You
• Jason Weinsieder
• Linda Wilken-Delreal
• Pam Lorraine Wingerter-Garcia, MS, RDN, CDN, CDCES
• Patricia Bowie Witherspoon, LCSW
• Woodhaven Optical LTD
• Woodhaven Scripts Inc
• Woodrich Consultation Center (anthony lerro)
• Jennifer Wu
• X Collado Dental Center

• Primary Care Clinic/Center in Ozone Park, NY
• Providers in Ozone Park, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.