Taeyong Kim, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305209975 Issued in VA

Practice address

9115 Lamont Ave Apt 2K
Elmhurst, NY 11373-2731

Phone

(909) 815-1269

NPI assigned

Feb 10, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

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.

• Four Seasons Physical Therapy P.C.

  • Physical Therapist
  • New York, NY
  • NPI 1285417097
  NPD Authorized official
• Taeyong Kim Acupuncture PC

  • Acupuncturist
  • Albertson, NY
  • NPI 1538829049
  NPD Authorized official

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1235597824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 LAMONT AVE APT 2K",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113732731",
            "telephone_number": "909-815-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 LAMONT AVE APT 2K",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113732731",
            "telephone_number": "909-815-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAEYONG",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25837",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039812",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Kyunghwa Kim, PHARM.D.
• Sarah Youngsoul Kim
• Sora Kim, FNP
• Suji Kim
• Sun Ja Kim, NP
• Vivian Minju Kim, NP
• Woo Suk Kim, DO
• Yong R Kim, M.D.
• Irina Kimyagar, RDE
• Kinetix Professional Management, Inc.

• Physical Therapist in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.