Individual provider Active NPI

Lily Kim, DO

  • Obstetrics & Gynecology Physician
  • Jersey City, NJ
National Provider Identifier
1356832216
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MB11475500 Issued in NJ
Practice address
435 Central Ave
Jersey City, NJ 07307-2760
Phone
(646) 809-1759
NPI assigned
May 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MB11475500 NJ Primary

Addresses

Primary practice location

435 Central Ave
Jersey City, NJ 07307-2760

Mailing address

435 Central Ave
Jersey City, NJ 07307-2760
Phone (646) 809-1759

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
I20240820003406 NY Practitioner - Obstetrics/Gynecology 1052656378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

159 E 53Rd St
New York, NY 10022-4602
Phone (646) 754-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11475500NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 1, 2024 Accepting new patients
New York University Obstetrics & Gynecology CurrentSince Aug 1, 2024 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

159 E 53rd St
Fl 4
New York, NY 10022
Phone (646) 754-1561

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Interoperability endpoints

  • Direct secure messaging: lkim143672@nyumc.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1356832216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072760",
            "telephone_number": "646-809-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072760",
            "telephone_number": "646-809-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LILY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MB11475500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.