Main Kim, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01810000 Issued in NJ

Practice address

700 Palisadium Dr
Cliffside Park, NJ 07010-3239

Phone

(201) 917-3494

NPI assigned

Aug 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Fleet

  • Physical Therapy Clinic/Center
  • Fort Lee, NJ
  • NPI 1659958445
  NPD Authorized official
• Playhab Rehab LLC

  • Physical Therapist
  • Englewood Cliffs, NJ
  • NPI 1497217632
  NPD (past) Authorized official

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1417438375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 37TH STREET",
            "address_2": "UNIT 404",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "07087",
            "telephone_number": "201-328-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PALISADIUM DR",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070103239",
            "telephone_number": "201-917-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MAIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA0180000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01810000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Nicholas Karkantzelis, DPT
• Shady A Khalil, DMD
• Francesca Kim, L.AC. MSTOM, COS
• Hyein Kim, OD
• Jimmy Kim, JAMES KIM
• So Jung Kim, M.S.E.D.
• Kipnis Orthopaedic Rehabilitation Institute PC
• Ilena Kipnis, PT
• George Klafter
• Jaeyoung Kleinfeld, L.AC

• Physical Therapist in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.