Minjae Kim, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F308223 Issued in NY

Practice address

2015 Grand Concourse
Bronx, NY 10453-4303

Phone

(718) 299-7295

Fax

(718) 299-6797

NPI assigned

Aug 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Minjae Kim Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Ny Premier Medical Practice, PC

  • Interventional Pain Medicine Physician
  • Flushing, NY
  • NPI 1881986743
  Medicare reassignment
• Andrew Yang, MD P.C.

  • Orthopaedic Surgery Physician
  • Bayside, NY
  • NPI 1619706082
  NPD (past)
• Atlas Ipa, LLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1912305509
  NPD (past)
• Shakespeare Operating LLC

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1720634538
  NPD (past)

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306361795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581000",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295",
            "fax_number": "718-299-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINJAE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINJAE",
            "last_name": "KIM",
            "prefix": "MR.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• May Kim
• Michael Jae Woo Kim, NP
• Mihye Kim, NP
• Min Ji Kim, MD
• Min Ju Kim
• Miple Kim, OTR/L
• Moonyong Kim, D.D.S.
• Nam Hee Kim
• Nigel Jason Kim, D.D.S.
• Oksook Kim, NP

• Adult Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.