Active NPI
Kenneth Kim
- Student in an Organized Health Care Education/Training Program
- Jamaica, NY
National Provider Identifier
1164914339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 9027 Sutphin Blvd
Jamaica, NY 11435-3647 - Phone
- (718) 526-8400
- NPI assigned
- Jun 4, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
9027 Sutphin Blvd
Jamaica, NY 11435-3647
Mailing address
9027 Sutphin Blvd
Jamaica, NY 11435-3647
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240624003362 | NY | Order and Referring Only - Mental Health Counselor | 8123561776 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transitional Services for Ny | Single Specialty | Past | Accepting new patients |
| Transitional Services for New York, Inc | Single Specialty | Past | Accepting new patients |
| Transitional Services for New York,Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Jamaica, NY
- NPI 1457418337
Single Specialty
-
- Community/Behavioral Health Agency
- Jamaica, NY
- NPI 1861644148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1164914339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9027 SUTPHIN BLVD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114353647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9027 SUTPHIN BLVD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114353647",
"telephone_number": "718-526-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KENNETH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-04",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.