Individual provider Active NPI

Ju Ee Kim, MD

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1376559427
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
174383 Issued in NY
Practice address
2525 Kings Hwy
Brooklyn, NY 11229-1705
Phone
(718) 692-5300
Fax
(516) 437-4167
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 174383 NY Primary

Addresses

Primary practice location

2525 Kings Hwy
Brooklyn, NY 11229-1705

Mailing address

1981 Marcus Ave
Suite 208
New Hyde Park, NY 11042-1038
Phone (718) 670-1651

Other identifiers 1

IdentifierTypeStateIssuer
01359099MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1376559427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 MARCUS AVE",
            "address_2": "SUITE 208",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421038",
            "telephone_number": "718-670-1651",
            "fax_number": "516-437-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291705",
            "telephone_number": "718-692-5300",
            "fax_number": "516-437-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JU",
        "middle_name": "EE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "174383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01359099",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.