Individual provider Active NPI

Miok Im

  • Family Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1265873293
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338174 Issued in NY
Practice address
4332 22ND St Ste 203
Long Island City, NY 11101-5077
Phone
(551) 395-7952
Fax
(620) 877-9147
NPI assigned
Jul 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 338174 NY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405461 NY

Addresses

Primary practice location

4332 22ND St Ste 203
Long Island City, NY 11101-5077

Mailing address

4332 22ND St Ste 203
Long Island City, NY 11101-5077
Phone (551) 395-7952

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
I20140930001651 NY Practitioner - Nurse Practitioner 1951521707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balveen Singh DO PCGroup PAC ID 5496054298, 5 clinicians

Practice addresses (Care Compare)

216 Congers Rd
BLDG 3
New City, NY 10956-6261
Phone (845) 821-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
405461NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbeing Clinic PC Psychiatric/Mental Health CurrentSince Mar 13, 2025 Accepting new patients
Balveen Singh DO PC CurrentSince Mar 13, 2025 Accepting new patients

Locations

4332 22nd St
Ste 203
Long Island City, NY 11101
Phone (347) 426-6072

60 Prospect Ave
Fl 3
Middletown, NY 10940
Phone (845) 480-6678

216 Congers Rd
Bldg 3
New City, NY 10956
Phone (845) 480-6678

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.

NPI Registry JSON

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

{
    "created_epoch": "1373068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1265873293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4332 22ND ST STE 203",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015077",
            "telephone_number": "551-395-7952",
            "fax_number": "620-877-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4332 22ND ST STE 203",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015077",
            "telephone_number": "551-395-7952",
            "fax_number": "620-877-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "MIOK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-06",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338174",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.