Organization Active NPI

1317 Medical, P.C.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1124068929
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
1317 MEDICAL, P.C.
Practice address
1317 3Rd Ave
7TH Floor
New York, NY 10021-2995
Phone
(212) 794-0240
Fax
(212) 570-2038
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter Sungwon Kim, M.D.
Title
President
Phone
(212) 794-0240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1317 3Rd Ave
7TH Floor
New York, NY 10021-2995

Mailing address

1317 3Rd Ave
7TH Floor
New York, NY 10021-2995
Phone (212) 794-0240

National Provider Directory

National Provider Directory

Locations

1317 3rd Ave
Fl 7
New York, NY 10021
Phone (212) 570-1816

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124068929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 3RD AVE",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212995",
            "telephone_number": "212-794-0240",
            "fax_number": "212-570-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 3RD AVE",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212995",
            "telephone_number": "212-794-0240",
            "fax_number": "212-570-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1317 MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "SUNGWON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-794-0240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.