Individual provider Active NPI

Hyun Ju Lim, AGPCNP

  • Adult Health Nurse Practitioner
  • Altamont, NY
National Provider Identifier
1376299537
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F310670 Issued in NY
Practice address
428 Ny-146
Altamont, NY 12009-4409
Phone
(872) 231-3162
Fax
(702) 977-1496
NPI assigned
Feb 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F310670 NY Primary

Addresses

Primary practice location

428 Ny-146
Altamont, NY 12009-4409

Mailing address

PO Box 22239
New York, NY 10087-0001
Phone (702) 899-0595

Other identifiers 1

IdentifierTypeStateIssuer
07654328MedicaidNY

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
I20220328001905 NY Practitioner - Nurse Practitioner 9335534494 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Health Rehabilitation LLCGroup PAC ID 4284952615, 153 clinicians

Practice addresses (Care Compare)

428 Ny Route 146
Altamont, NY 12009
Phone (201) 654-6397

Merit-based Incentive Payment System (MIPS)

Final score
87.66 of 100Reported as group
Quality
73.72
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F310670NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mikram Jafri MD PC CurrentSince Jul 31, 2023 Accepting new patients
Rd Medical Professional Services PC CurrentSince Mar 1, 2022 Accepting new patients
National Health Rehabilitation LLC CurrentSince Dec 19, 2022 Accepting new patients

Locations

325 Northern Blvd
Albany, NY 12204
Phone (518) 328-3605

428 State Route 146
Altamont, NY 12009
Phone (518) 861-5141

7120 110th St
Forest Hills, NY 11375
Phone (718) 305-1190

228 E Route 59
Nanuet, NY 10954
Phone (718) 280-5436

32 Cedar Ln
Ossining, NY 10562
Phone (914) 762-1600

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

700 E Brighton Ave
Syracuse, NY 13205
Phone (315) 469-5570

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

100 New Turnpike Rd
Troy, NY 12182
Phone (518) 235-1410

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

338 Harris Hill Rd
Ste 207
Williamsville, NY 14221

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.

NPI Registry JSON

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1376299537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22239",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870001",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 NY-146",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120094409",
            "telephone_number": "872-231-3162",
            "fax_number": "702-977-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "HYUN JU",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07654328",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamont, NY

Sources for this page

Verify at the official NPI Registry.