Organization Active NPI

A Kim Medical PC

  • Urology Physician
  • Stony Brook, NY
National Provider Identifier
1467622266
Registry record updated Aug 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
167661-1 Issued in NY
Legal business name
A KIM MEDICAL PC
Practice address
2500 Nesconset Hwy
Building 21a
Stony Brook, NY 11790-2555
Phone
(631) 751-4000
Fax
(631) 246-6176
NPI assigned
Mar 7, 2008
Last updated
Aug 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2009

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

Authorized official

Name
Dr. Albert N Kim, MDNPI 1548234156
Title
President
Phone
(631) 751-4000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 167661-1 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy
Building 21a
Stony Brook, NY 11790-2555

Mailing address

PO Box 29066
New York, NY 10087-9066
Phone (631) 751-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080714000352 NY Part B Supplier - Clinic/Group Practice 0547333254 Receives reassigned benefits from 6 practitioners
Practice locations: Stony Brook, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1078647A Kim Medical PC2500 Nesconset Hwy, BLDG 21a ,Ste 76, Stony Brook, NY 11790ComplianceOct 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249344000000",
    "number": "1467622266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29066",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879066",
            "telephone_number": "631-751-4000",
            "fax_number": "631-246-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "BUILDING 21A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-4000",
            "fax_number": "631-246-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A KIM MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2009-08-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-751-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "167661-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.