Organization Active NPI

Essential Allergy, Asthma, Atopy Familycare, P.C.

  • Allergy & Immunology Physician
  • Bronx, NY
National Provider Identifier
1417494766
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
246281 Issued in NY
Legal business name
ESSENTIAL ALLERGY, ASTHMA, ATOPY FAMILYCARE, P.C.
Practice address
3130 Grand Concourse
Ste 1N
Bronx, NY 10458-1213
Phone
(914) 610-0406
Fax
(718) 561-8499
NPI assigned
Jan 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Minsoo Kim, M.D.NPI 1164621249
Title
Owner
Phone
(914) 610-0406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X 246281 NY Primary
Medical Specialty Clinic/Center 261QM2500X 246281 NY

Addresses

Primary practice location

3130 Grand Concourse
Ste 1N
Bronx, NY 10458-1213

Mailing address

3130 Grand Concourse
Ste 1N
Bronx, NY 10458-1213
Phone (914) 610-0406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322002569 NY Part B Supplier - Clinic/Group Practice 8527343144 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY; Great Neck, NY

National Provider Directory

National Provider Directory

Locations

3130 Grand Concourse
Ste 1N
Bronx, NY 10458
Phone (718) 365-0892

107 Northern Blvd
Ste 303
Great Neck, NY 11021
Phone (516) 504-0005

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1417494766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "STE 1N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "914-610-0406",
            "fax_number": "718-561-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "STE 1N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "914-610-0406",
            "fax_number": "718-561-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL ALLERGY, ASTHMA, ATOPY FAMILYCARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MINSOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-610-0406",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "246281",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "246281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.