Dr. P.Kim Podiatry, P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

DR. P.KIM PODIATRY, P.C.

Practice address

6083 Myrtle Ave
Ridgewood, NY 11385-5908

Phone

(718) 381-8402

Fax

(888) 720-0690

NPI assigned

Jan 19, 2021

Last updated

Jul 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Y Kim, DPMNPI 1831477280

Title

President

Phone

(267) 979-9670

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Dr. P.Kim Podiatry, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Ridgewood, NY
  • NPI 1396102828

  7517256332

  Same PAC ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Y Kim, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Ridgewood, NY
  • NPI 1831477280
  NPD Authorized official

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1164012746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18820B 69TH AVE APT 3B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653705",
            "telephone_number": "646-762-4331",
            "fax_number": "888-720-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6083 MYRTLE AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855908",
            "telephone_number": "718-381-8402",
            "fax_number": "888-720-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. P.KIM PODIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-979-9670",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04389222",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Dong
• Vincent John Dorotan
• Doru Buza MD
• Megan Downing
• Dr. Fernandez Dental Office
• Dr. P.Kim Podiatry, P.C.
• Dr. Ravi Medical PC
• Duane Reade (Duane Reade #14179)
• Duane Reade (Duane Reade #14314)
• Thomas Dube, PA

• Foot & Ankle Surgery Podiatrist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.