Individual provider Active NPI

Jessica W. Lim, M.D.

  • Otolaryngology Physician
  • New York, NY
National Provider Identifier
1114902723
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
192554-1 Issued in NY
Practice address
186 E 76TH St
Second Floor
New York, NY 10021-2844
Phone
(212) 434-2323
Fax
(212) 434-6885
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 192554-1 NY Primary

Addresses

Primary practice location

186 E 76TH St
Second Floor
New York, NY 10021-2844

Mailing address

186 E 76TH St
Second Floor
New York, NY 10021-2844
Phone (212) 434-2323

Other identifiers 1

IdentifierTypeStateIssuer
01859787MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000315 NY Practitioner - Otolaryngology 7315023728 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
192554NYMDLicensed Practical Nurse
192554-1NYMDOtolaryngology Physician
195554NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Hospital Medical, PC Otolaryngology CurrentSince Mar 28, 2016 Accepting new patients
Wyckoff Professional Medical Services, PC CurrentSince Jan 1, 2021 Accepting new patients
University Physicians of Brooklyn, Inc. Otolaryngology Past Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

7554 Metropolitan Ave
Middle Vlg, NY 11379
Phone (718) 326-0400

186 E 76th St
Fl 2
New York, NY 10021
Phone (212) 327-3000

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1114902723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 E 76TH ST",
            "address_2": "SECOND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212844",
            "telephone_number": "212-434-2323",
            "fax_number": "212-434-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 E 76TH ST",
            "address_2": "SECOND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212844",
            "telephone_number": "212-434-2323",
            "fax_number": "212-434-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "JESSICA",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "192554-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01859787",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.