NPIMap

Individual provider Active NPI

Paul Kim, MD

  • Diagnostic Radiology Physician
  • Cortlandt Manor, NY
National Provider Identifier
1194716027
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
197623 Issued in NY
Practice address
1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone
(914) 734-3935
Fax
(914) 734-3838
NPI assigned
Oct 31, 2005
Last updated
Jul 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 197623 NY Primary

Addresses

Primary practice location

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144

Mailing address

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (914) 737-3935

Other identifiers 2

IdentifierTypeStateIssuer
10495675OtherCAQH #
86Y803K221OtherNYPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040223000357 NY Practitioner - Diagnostic Radiology 5698661221
I20050819000436 NJ Practitioner - Diagnostic Radiology 5698661221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Icahn School of Medicine at Mount Sinai, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peace Health Partners, PCGroup PAC ID 6709776222, 33 clinicians

Practice addresses (Care Compare)

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 833-3280

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peace Health Partners, PC Diagnostic Radiology CurrentSince Apr 1, 2022 Accepting new patients
Hoboken MRI, P.a. Past Accepting new patients
Northeast Radiology PC Diagnostic Radiology Past Accepting new patients
Cardiology Consultantsof Westchester, PC Past Accepting new patients
Doshi Diagnostic Imaging Services PC Diagnostic Radiology Past Accepting new patients

Locations

3 University Plz
Ste 205
Hackensack, NJ 07601

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

718 Teaneck Rd
Fl 3
Teaneck, NJ 07666
Phone (201) 803-3065

Interoperability endpoints

  • Direct secure messaging: paul.kim@direct.hvhc.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1194716027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 CROMPOND RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674144",
            "telephone_number": "914-737-3935",
            "fax_number": "914-734-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 CROMPOND RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674144",
            "telephone_number": "914-734-3935",
            "fax_number": "914-734-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "197623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH #",
            "identifier": "10495675",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "86Y803K221",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortlandt Manor, NY

Sources for this page

Verify at the official NPI Registry.