Active NPI
Youn Jea Kim, NP
- Family Nurse Practitioner
- Buffalo, NY
National Provider Identifier
1376908442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 340203
- Practice address
- 550 Orchard Park Rd Ste A110
Buffalo, NY 14224-2646 - Phone
- (716) 650-5720
- NPI assigned
- Dec 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 340203 | NY | |
| Family Nurse Practitioner | 363LF0000X | 340203 | NY | Primary |
Addresses
Primary practice location
550 Orchard Park Rd Ste A110
Buffalo, NY 14224-2646
Mailing address
1170 Maple Rd
Williamsville, NY 14221-3440
Phone (213) 880-2538
Other practice location 1
609 Central Ave
Dunkirk, NY 14048-2538
Phone (716) 650-5720
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
550 Orchard Park Rd
Suite A110
West Seneca, NY 14224-2646
Phone (716) 650-5720
Hospital & facility affiliations
- Olean General Hospital
- Brooks-TLC Hospital System, Inc
- Jones Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wny Medical PC | Family | Current | Accepting new patients |
| Near Me Dermatology PLLC | Dermatology | Current | Accepting new patients |
| Near Me Dermatology PLLC | Dermatology | Current | Accepting new patients |
| Ub Family Medicine, Inc | Past | Accepting new patients |
Locations
5210 Linton Blvd
Ste 307
Delray Beach, FL 33484
Phone (561) 499-0660
112 W Main St
Allegany, NY 14706
Phone (716) 373-0700
4979 Harlem Rd
Buffalo, NY 14226
Phone (716) 923-4380
609 Central Ave
Dunkirk, NY 14048
Phone (716) 363-6960
Organizations & group practices 4
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.
-
- Dermatology Physician
- West Seneca, NY
- NPI 1083387898
-
- Dermatology Physician
- West Seneca, NY
- NPI 1326712209
-
- Family Medicine Physician
- Williamsville, NY
- NPI 1942294467
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Derby, NY
- NPI 1225654494
Hospital
-
- General Acute Care Hospital
- Dunkirk, NY
- NPI 1215917224
-
- General Acute Care Hospital
- Olean, NY
- NPI 1225083074
-
- Medicare Defined Swing Bed Hospital Unit
- Olean, NY
- NPI 1699715904
-
- General Acute Care Hospital
- Wellsville, NY
- NPI 1720030703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1376908442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 MAPLE RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142213440",
"telephone_number": "213-880-2538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 ORCHARD PARK RD STE A110",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142242646",
"telephone_number": "716-650-5720"
}
],
"practiceLocations": [
{
"address_1": "609 Central Ave",
"address_purpose": "LOCATION",
"city": "Dunkirk",
"state": "NY",
"postal_code": "140482538",
"country_code": "US",
"telephone_number": "716-650-5720",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "YOUN JEA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-16",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "340203",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "340203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.