Active NPI
Dongwoo Kim, LAC
- Acupuncturist
- Fort Lee, NJ
National Provider Identifier
1356725139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 25MZ00108600
- Practice address
- 1063 Palisade Ave
Fort Lee, NJ 07024-6359 - Phone
- (347) 757-1111
- NPI assigned
- Jul 12, 2015
- Last updated
- Apr 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00108600 | NJ | Primary |
Addresses
Primary practice location
1063 Palisade Ave
Fort Lee, NJ 07024-6359
Mailing address
1063 Palisade Ave
Fort Lee, NJ 07024-6359
Phone (347) 757-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MZ00108600 | Other | NJ | NJ OFFICE OF THE ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00108600 | NJ | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743465600000",
"number": "1356725139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1063 PALISADE AVE",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070246359",
"telephone_number": "347-757-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1063 PALISADE AVE",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070246359",
"telephone_number": "347-757-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DONGWOO",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-12",
"last_updated": "2025-04-01",
"certification_date": "2025-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00108600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NJ OFFICE OF THE ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS",
"identifier": "25MZ00108600",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.