Organization Active NPI

Yong Jun Kim MD PC

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1487868360
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236715 Issued in NY
Legal business name
YONG JUN KIM MD PC
Practice address
164-10 Northern Blvd
Suite # 206
Flushing, NY 11358
Phone
(718) 321-2940
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Dr. Yong Jun Kim, M.D.
Title
President
Phone
(718) 321-2940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 236715 NY Primary

Addresses

Primary practice location

164-10 Northern Blvd
Suite # 206
Flushing, NY 11358

Mailing address

54 Mott Ave
Roslyn, NY 11576-1612
Phone (718) 321-2940

National Provider Directory

National Provider Directory

Locations

16410 Northern Blvd
Ste 206
Flushing, NY 11358
Phone (718) 321-2940

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1487868360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MOTT AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761612",
            "telephone_number": "718-321-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164-10 NORTHERN BLVD",
            "address_2": "SUITE # 206",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11358",
            "telephone_number": "718-321-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONG JUN KIM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YONG JUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-321-2940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.