Kyu-Jin Kim, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

123715 Issued in NY

Practice address

7575 Firebird Lane
Manlius, NY 13104-9334

Phone

(315) 682-7185

NPI assigned

Oct 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1215289491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 FIREBIRD LANE",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "13104",
            "telephone_number": "315-682-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 FIREBIRD LANE",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049334",
            "telephone_number": "315-682-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYU-JIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "123715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Helf Karp, DDS
• Archana Kathpal, MD
• Scott Paul Kavanagh, D. MIN.
• Caroline W. Keib Cramer, MD
• Muhammad Sami Khan, MBBS
• Heather Ann Kipping-Regitano, L.C.S.W.-R.
• Christine Louise Kirkman, MSN,RN,PNP
• Pamela Tiller Knox, N.P.
• Erin Elizabeth Kolceski, M.S., CCC-SLP
• David M Konys, DDS,MS

• General Practice Physician in Manlius, NY
• Providers in Manlius, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.