Active NPI
Soo Jung Kim, N.P.
- Adult Health Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 306397
- Practice address
- 16 East 60TH Street
4TH Floor, Suite 404
New York, NY 10022 - Phone
- (646) 888-3278
- NPI assigned
- Apr 10, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 306397 | NY | Primary |
Addresses
Primary practice location
16 East 60TH Street
4TH Floor, Suite 404
New York, NY 10022
Mailing address
1275 York Avenue
Box 205
New York, NY 10065
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: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1275 York Ave
New York, NY 10065-6094
Phone (212) 639-2000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.55 of 100
- Quality
- 82.52
- Improvement activities
- 40
- Cost
- 72.02
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306397 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Consultation Group | Current | Accepting new patients |
Locations
633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
1275 York Ave
#205
New York, NY 10065
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- skim21701@mskcc.direct-ci.com
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- New York, NY
- NPI 1053382523
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
-
- Special Hospital
- New York, NY
- NPI 1770046351
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
-
- General Acute Care Hospital
- Montvale, NJ
- NPI 1841650330
-
- General Acute Care Hospital
- Middletown, NJ
- NPI 1528428521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418860800000",
"number": "1215370150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 YORK AVENUE",
"address_2": "BOX 205",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 EAST 60TH STREET",
"address_2": "4TH FLOOR, SUITE 404",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10022",
"telephone_number": "646-888-3278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SOO JUNG",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-10",
"last_updated": "2014-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "306397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.