Individual provider Active NPI

Hyosun Kim, NP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1477906709
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F3417371 Issued in NY
Practice address
3374 191St St
Flushing, NY 11358-1940
Phone
(646) 387-3419
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F3417371 NY Primary
Registered Nurse 163W00000X 7074021 NY

Addresses

Primary practice location

3374 191St St
Flushing, NY 11358-1940

Mailing address

8701 56TH Ave
FL 1
Elmhurst, NY 11373-4831
Phone (718) 457-0002

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002001703 NY Practitioner - Nurse Practitioner 3870845860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

220 Front St
New York, NY 10038-2033
Phone (212) 385-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7074021NYMDRegistered Nurse
F3417371NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr WW Dermatology PLLC CurrentSince Sep 1, 2018 Accepting new patients
W&W Millennium Dermatology P.C. CurrentSince Jan 1, 2012 Accepting new patients
Derm Specs of PA PLLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

8701 56th Ave
Fl 1
Elmhurst, NY 11373
Phone (718) 457-0002

8516 Queens Blvd
#1
Elmhurst, NY 11373
Phone (718) 457-0002

1027 46th Ave
Fl 1
Long Island City, NY 11101

139 Centre St
Ste 215
New York, NY 10013
Phone (212) 343-1257

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1477906709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 56TH AVE",
            "address_2": "FL 1",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734831",
            "telephone_number": "718-457-0002",
            "fax_number": "718-457-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3374 191ST ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113581940",
            "telephone_number": "646-387-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYOSUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F3417371",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "7074021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.