Individual provider Active NPI

Daniel Kim, D.O.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1255693297
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
296116 Issued in NY
Practice address
201 E 65TH St
New York, NY 10065-6701
Phone
(212) 879-4700
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 296116 NY Primary

Addresses

Primary practice location

201 E 65TH St
New York, NY 10065-6701

Mailing address

201 E 65TH St
New York, NY 10065-6701
Phone (212) 879-4700

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521001603 NY Practitioner - Family Practice 2668871773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Office of Manhattan PLLCGroup PAC ID 8426158833, 34 clinicians

Practice addresses (Care Compare)

112 W 72ND St
Suite a
New York, NY 10023-3305
Phone (212) 223-0349

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296116NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Office of Manhattan PLLC CurrentSince Jan 30, 2021 Accepting new patients

Locations

112 W 72nd St
Ste A
New York, NY 10023
Phone (212) 223-0349

201 E 65th St
New York, NY 10065
Phone (212) 879-4700

112 W 72nd St
New York, NY 10023
Phone (212) 223-0349

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.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1255693297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 65TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656701",
            "telephone_number": "212-879-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 65TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656701",
            "telephone_number": "212-879-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "296116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.