Individual provider Active NPI

Yoohyun Kim, PA

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1457811630
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060278 Issued in PA
Practice address
51 N 39TH St
Philadelphia, PA 19104-2640
Phone
(215) 662-9990
Fax
(215) 243-3297
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA060278 PA Primary

Addresses

Primary practice location

51 N 39TH St
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190619001163 NY Practitioner - Physician Assistant 1153655501 Reassigns benefits to 1 organization
I20230926003742 PA Practitioner - Physician Assistant 1153655501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3801 Filbert St Mab
102 Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9436

51 N 39TH Street Mab
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH Stret
Hospital Med Presby
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Abington Memorial Hospital CurrentSince Sep 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 18, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 18, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2019 Accepting new patients
Abington Memorial Hospital CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2019 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

1200 Old York Rd
Ste 2B
Abington, PA 19001
Phone (215) 481-2222

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1457811630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9990",
            "fax_number": "215-243-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9990",
            "fax_number": "215-243-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOOHYUN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.