Individual provider Active NPI

Austin Jaehyun Kim, MD

  • Internal Medicine Physician
  • Jersey City, NJ
National Provider Identifier
1194474924
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12804900 Issued in NJ
Practice address
355 Grand St
Jersey City, NJ 07302-4321
Phone
(201) 915-2000
NPI assigned
Mar 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 25MA12804900 NJ
Internal Medicine Physician 207R00000X 25MA12804900 NJ Primary

Addresses

Primary practice location

355 Grand St
Jersey City, NJ 07302-4321

Mailing address

355 Grand St
Jersey City, NJ 07302-4321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220628003756 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3274913876

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12804900NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1194474924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "201-915-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "AUSTIN",
        "middle_name": "JAEHYUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-21",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA12804900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12804900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.