Individual provider Active NPI

Jong Hoon Kim, FNP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1154106813
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F351965 Issued in NY
Practice address
19214 Northern Blvd # 2D
Flushing, NY 11358-2955
Phone
(718) 762-3240
Fax
(855) 770-4386
NPI assigned
Aug 30, 2023
Last updated
May 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F351965 NY Primary

Addresses

Primary practice location

19214 Northern Blvd # 2D
Flushing, NY 11358-2955

Mailing address

1A Locust PL
Huntington Station, NY 11746-4233
Phone (347) 971-9019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F351965NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of New York, Inc. CurrentSince Oct 9, 2023 Accepting new patients
Kanghan Medical Services, P.C. PastSince Nov 1, 2005 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

5232 Witz Dr
North Syracuse, NY 13212
Phone (315) 632-5960

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAACBD

Organizations & group practices 2

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": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1154106813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A LOCUST PL",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464233",
            "telephone_number": "347-971-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19214 NORTHERN BLVD # 2D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582955",
            "telephone_number": "718-762-3240",
            "fax_number": "855-770-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONG HOON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-30",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.