Individual provider Active NPI

Susan Kim, MD

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1154496958
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
214422 Issued in NY
Practice address
234 E 149TH St
Bronx, NY 10451-5504
Phone
(718) 579-5734
Fax
(718) 579-4963
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 214422 NY Primary

Addresses

Primary practice location

234 E 149TH St
Bronx, NY 10451-5504

Mailing address

316 Franklin CT
Edgewater, NJ 07020-1603
Phone (201) 313-1993

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
I20041228000503 NY Practitioner - NephrologyPractitioner - Internal Medicine 4284692955 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
214422NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harlem Medical Associates PC CurrentSince Mar 1, 2020 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Jul 1, 2000 Accepting new patients
Lincon Medical and Mental Center Past Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

45 Research Way
Ste 206
Setauket, NY 11733
Phone (631) 575-9300

Networks

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

Interoperability endpoints

  • Direct secure messaging: skim839168@nychhc.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154496958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 FRANKLIN CT",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201603",
            "telephone_number": "201-313-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5734",
            "fax_number": "718-579-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "214422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.