Individual provider Active NPI

Jessica Kim, NP

  • Adult Health Nurse Practitioner
  • Woodbury, NY
National Provider Identifier
1245941046
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
311107 Issued in NY
Practice address
95 Froehlich Farm Blvd
Woodbury, NY 11797-2930
Phone
(516) 302-8532
Fax
(516) 838-6182
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 311107 NY Primary

Addresses

Primary practice location

95 Froehlich Farm Blvd
Woodbury, NY 11797-2930

Mailing address

95 Froehlich Farm Blvd
Woodbury, NY 11797-2930
Phone (516) 302-8532

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241017002386 NY Practitioner - Nurse Practitioner 1759813512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

4 Ohio Dr
New Hyde Park, NY 11042-1111
Phone (516) 775-4545

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
311107NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, P.C CurrentSince Oct 1, 2024 Accepting new patients

Locations

510 Hicksville Rd
Massapequa, NY 11758
Phone (516) 729-2626

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

4 Ohio Dr
New Hyde Park, NY 11042
Phone (516) 519-8260

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

471 Montauk Hwy
West Islip, NY 11795
Phone (631) 376-2260

95 Froehlich Farm Blvd
Woodbury, NY 11797

Networks

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

Interoperability endpoints

  • Direct secure messaging: jkim53264@direct-chsli.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1245941046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 FROEHLICH FARM BLVD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972930",
            "telephone_number": "516-302-8532",
            "fax_number": "516-838-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 FROEHLICH FARM BLVD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972930",
            "telephone_number": "516-302-8532",
            "fax_number": "516-838-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.