Chan Mi Kim, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F339292-01 Issued in NY

Practice address

3834 Parsons Blvd # 1D
Flushing, NY 11354-5843

Phone

(718) 762-1710

NPI assigned

Jan 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Choi Medical Services PLLC

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1447464185
  NPD
• Union Square Medical Imaging and Mammography PC

  • Mammography Clinic/Center
  • New York, NY
  • NPI 1912037102
  NPD (past)

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1336854181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3928 217TH ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3834 PARSONS BLVD # 1D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545843",
            "telephone_number": "718-762-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHAN MI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339292-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bong Song Kim, M.D.
• Bora V Kim, D.O.
• Bryan S Kim, DMD
• Carey Kim, M.D.
• Carol Kim
• Changyoung Kim
• CHI Kim, PA
• Christine Ejin Kim, M.D.
• Christine Sun Kim, MD
• Claire Kim, LMT

• Family Nurse Practitioner in Flushing, NY
• Providers in Flushing, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.