Individual provider Active NPI

Oksook Kim, NP

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1134467954
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F306157-1 Issued in NY
Practice address
2024 Creston Ave
Bronx, NY 10453-4244
Phone
(718) 299-7295
NPI assigned
Jan 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F306157-1 NY Primary

Addresses

Primary practice location

2024 Creston Ave
Bronx, NY 10453-4244

Mailing address

2024 Creston Ave
Bronx, NY 10453-4244
Phone (718) 299-7295

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131022000584 NY Practitioner - Nurse Practitioner 8123253408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Beacon Health Medical PCGroup PAC ID 1658804760, 36 clinicians

Practice addresses (Care Compare)

17 W 9TH St
Brooklyn, NY 11231-2501
Phone (718) 599-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
340854NYMDLicensed Practical Nurse
306157NYMDUrology Physician
F306157-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health Medical PC CurrentSince Oct 1, 2024 Accepting new patients
Park Avenue Pediatrics, P.C. CurrentSince May 1, 2020 Accepting new patients
Parcare Community Health Network Inc CurrentSince May 1, 2020 Accepting new patients
Parcare Community Health Network Inc CurrentSince May 1, 2020 Accepting new patients
Ilyagu Medical PC Past Accepting new patients

Locations

3400 Cannon Pl
Bronx, NY 10463
Phone (718) 694-9000

6010 Bay Pkwy
Ste 902
Brooklyn, NY 11204
Phone (718) 475-1700

17 W 9th St
Brooklyn, NY 11231
Phone (718) 599-9090

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

Networks

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

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1134467954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 CRESTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534244",
            "telephone_number": "718-299-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 CRESTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534244",
            "telephone_number": "718-299-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "OKSOOK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F306157-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.