Active NPI
Joshua Seokju Kim
- Student in an Organized Health Care Education/Training Program
- Flushing, NY
National Provider Identifier
1467207282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5645 Main St
Flushing, NY 11355-5045 - Phone
- (818) 599-2168
- NPI assigned
- Apr 23, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5645 Main St
Flushing, NY 11355-5045
Mailing address
2745 Piedmont Ave Apt 203
Montrose, CA 91020-1371
Phone (818) 599-2168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260112003054 | WI | Order and Referring Only - Physical Medicine and Rehabilitation | 9739665464 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1467207282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2745 PIEDMONT AVE APT 203",
"city": "MONTROSE",
"state": "CA",
"postal_code": "910201371",
"telephone_number": "818-599-2168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5645 MAIN ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "818-599-2168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOSHUA",
"middle_name": "SEOKJU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-23",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.