Individual provider Active NPI

John Yohan Kim, M.D.

  • Allergy & Immunology Physician
  • Medford, NJ
National Provider Identifier
1467442384
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
25MA09095500 Issued in NJ
Practice address
103 Old Marlton Pike
Suite 211
Medford, NJ 08055-8772
Phone
(856) 576-5742
Fax
(856) 519-5457
NPI assigned
Oct 22, 2005
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 255713 NY
Allergy & Immunology Physician 207K00000X 25MA09095500 NJ Primary
Internal Medicine Physician 207R00000X 255713 NY

Addresses

Primary practice location

103 Old Marlton Pike
Suite 211
Medford, NJ 08055-8772

Mailing address

660 White Plains Rd FL 4
Tarrytown, NY 10591-5187
Phone (914) 333-5801

Other identifiers 2

IdentifierTypeStateIssuer
3410623OtherNJCIGNA
3881423000OtherNJAMERIHEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120713000153 NJ Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 9830374503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

103 Old Marlton Pike
Suite 211
Medford, NJ 08055-8772
Phone (856) 576-5742

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.54 of 100Reported as group
Quality
89.88
Promoting interoperability
87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
255713NYMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates LLP Allergy & Immunology CurrentSince Jan 1, 2025 Accepting new patients
ENT and Allergy Associates of Pennsylvania PLLC Allergy & Immunology PastSince Nov 24, 2024 Accepting new patients

Locations

103 Old Marlton Pike
Ste 211
Medford, NJ 08055
Phone (609) 953-7500

103 Old Marlton Pike
Ste 225
Medford, NJ 08055
Phone (609) 953-7110

1131 Broad St
Ste 103
Shrewsbury, NJ 07702
Phone (732) 389-2438

620 N Broad St
Woodbury, NJ 08096
Phone (856) 602-4000

660 White Plains Rd
Fl 4
Tarrytown, NY 10591
Phone (914) 984-2546

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: john.kim@direct.entandallergy.nextgenshare.com
  • Direct secure messaging: jykim@advancedent.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1129939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1467442384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915187",
            "telephone_number": "914-333-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE",
            "address_2": "SUITE 211",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558772",
            "telephone_number": "856-576-5742",
            "fax_number": "856-519-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "middle_name": "YOHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-22",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "255713",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA09095500",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "255713",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3410623",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "3881423000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.