Active NPI
Crystal Kim, NP
- Psychiatric/Mental Health Nurse Practitioner
- New York, NY
National Provider Identifier
1154759702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F401642
- Practice address
- 601 W 113TH St
Suite 1a
New York, NY 10025-9700 - Phone
- (212) 305-2001
- NPI assigned
- Oct 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F401642 | NY | Primary |
Addresses
Primary practice location
601 W 113TH St
Suite 1a
New York, NY 10025-9700
Mailing address
60 W 57TH St
Apt 16F
New York, NY 10019-3953
Phone (201) 606-3264
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F401642 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CK NP Psychiatry, PLLC | Psychiatric/Mental Health | Current | Accepting new patients |
Locations
244 5th Ave
Ste K231
New York, NY 10001
Organizations & group practices 1
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Brooklyn, NY
- NPI 1245802081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1154759702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 W 57TH ST",
"address_2": "APT 16F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100193953",
"telephone_number": "201-606-3264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W 113TH ST",
"address_2": "SUITE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100259700",
"telephone_number": "212-305-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CRYSTAL",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-17",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F401642",
"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 Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.