Duck J Kim, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

110604 Issued in NY

Practice address

210 Cornelia Street
Suite #204
Plattsburgh, NY 12901-2396

Phone

(518) 563-8050

Fax

(518) 563-8352

NPI assigned

May 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1386858694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CORNELIA STREET",
            "address_2": "SUITE #204",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012396",
            "telephone_number": "518-563-8050",
            "fax_number": "518-563-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CORNELIA STREET",
            "address_2": "SUITE #204",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012396",
            "telephone_number": "518-563-8050",
            "fax_number": "518-563-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DUCK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "110604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD NORTHEASTERN",
            "identifier": "000405443001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "141603686",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00511922",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Keyser
• Irzam Khan, MD
• Susan Kier-Merrihew, NP
• Siobhan Mairead Kiernan, L.C.S.W.
• Douglas J Kim, MD
• Wanki Kim, DDS
• Elizabeth King
• Rachel King, OTR/L
• Kinney Homecare Equipment and Supplies, Inc.
• David L Kirkpatrick, OD

• Otolaryngology Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.