Individual provider Active NPI

Eden Kim

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1477969269
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
289581 Issued in NY
Practice address
450 Clarkson Ave
Brooklyn, NY 11203
Phone
(718) 245-3318
NPI assigned
Jul 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 289581 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Brooklyn, NY 11203

Mailing address

355 Stafford Ave
Staten Island, NY 10312-2856
Phone (718) 966-7440

Other practice location 1

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA, NV3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180508001535 NY Practitioner - Emergency Medicine 6709140338 Reassigns benefits to 9 organizations
I20230626002182 VA Practitioner - Emergency Medicine 6709140338 Reassigns benefits to 2 organizations
I20250227002078 NV Practitioner - Emergency Medicine 6709140338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.85 of 100Reported as group
Quality
79.23
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince May 1, 2023 Accepting new patients
Buffalo Emergency Associates LLP Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
United Medical Associates PC CurrentSince May 1, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Current Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Aug 6, 2018 Accepting new patients
Siena Emergency Medical Services, P.C. Emergency Medicine CurrentSince May 26, 2023 Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Feb 8, 2024 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Feb 8, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 1, 2023 Accepting new patients
Suny Health Science Center at Bklyn Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Jul 20, 2018 Accepting new patients
State of New York Comptrollers Office CurrentSince Jul 1, 2018 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Aug 6, 2018 Accepting new patients
Edwards MD PC Emergency Medicine CurrentSince Feb 1, 2025 Accepting new patients
United Medical Associates, P.C. CurrentSince May 1, 2022 Accepting new patients
Port Emergency Medical Services, P.C. Emergency Medicine CurrentSince May 26, 2023 Accepting new patients

Locations

1155 Raiders Way
Henderson, NV 89052
Phone (702) 369-7671

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

2605 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 891-2315

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

3669 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 662-0500

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1477969269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 STAFFORD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122856",
            "telephone_number": "718-966-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11203",
            "telephone_number": "718-245-3318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132031807",
            "country_code": "US",
            "telephone_number": "315-448-5101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "289581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.