Active NPI
Beom Soo Kim, MD
- Clinical Cardiac Electrophysiology Physician
- Manhasset, NY
National Provider Identifier
1477050995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- 309586
- Practice address
- 300 Community Dr
Manhasset, NY 11030-3816 - Phone
- (516) 562-0100
- NPI assigned
- Apr 11, 2018
- 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 |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 309586 | NY | Primary |
Addresses
Primary practice location
300 Community Dr
Manhasset, NY 11030-3816
Mailing address
60 Crittenden Blvd Apt 717
Rochester, NY 14620-4024
Phone (585) 397-4925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20181219003272 | NY | Order and Referring Only - Internal Medicine | 8527303536 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787097600000",
"number": "1477050995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 CRITTENDEN BLVD APT 717",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146204024",
"telephone_number": "585-397-4925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 COMMUNITY DR",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303816",
"telephone_number": "516-562-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BEOM SOO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-11",
"last_updated": "2026-08-19",
"certification_date": "2026-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "NY",
"license": "309586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.