Individual provider Active NPI

Young Ju Kim

  • Massage Therapist
  • Englewood Cliffs, NJ
National Provider Identifier
1487437760
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18KT00814500 Issued in NJ
Practice address
560 Sylvan Ave Ste 3150
Englewood Cliffs, NJ 07632-3179
Phone
(646) 725-4600
NPI assigned
Aug 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18KT00814500 NJ Primary

Addresses

Primary practice location

560 Sylvan Ave Ste 3150
Englewood Cliffs, NJ 07632-3179

Mailing address

560 Sylvan Ave Ste 3150
Englewood Cliffs, NJ 07632-3179
Phone (646) 725-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18KT00814500NJMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baruch Medical PC CurrentSince Aug 27, 2023 Accepting new patients

Locations

560 Sylvan Ave
Ste 3150
Englewood Cliffs, NJ 07632
Phone (646) 725-4600

Organizations & group practices 1

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": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1487437760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 SYLVAN AVE STE 3150",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323179",
            "telephone_number": "646-725-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 SYLVAN AVE STE 3150",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323179",
            "telephone_number": "646-725-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG JU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT00814500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.