Won Gi Im, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

107772 Issued in NY

Practice address

221 Broadway
Suite 303
Amityville, NY 11701

Phone

(631) 789-7429

Fax

(631) 789-8571

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1959

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

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

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.

• Bay Shore Medical Services, P.C.

  • Addiction Psychiatry Physician
  • Bay Shore, NY
  • NPI 1427379932
  NPD (past)
• Dr Marianne Hendrix MD PC

  • Psychiatry Physician
  • Smithtown, NY
  • NPI 1992980858
  NPD (past)
• Linda Low, Inc

  • Psychiatry Physician
  • Amityville, NY
  • NPI 1710047360
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1508932989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 BROADWAY",
            "address_2": "SUITE 303",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-789-7429",
            "fax_number": "631-789-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 BROADWAY",
            "address_2": "SUITE 303",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-789-7429",
            "fax_number": "631-789-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "WON GI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "107772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00190092",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hunter Ryan Iacovetti
• Franklyn P. Ianno, D.D.S.
• Lauren Iarrobino
• Caroline Margaret Ida, LMSW
• Ilene Jurmann, PH.D., Psychologist, P.C.
• Integrated Medical Professionals PLLC
• Danita Ionescu, MD
• Alison Manying Ip
• Island Foot and Ankle
• Island Medical Associates, P.C.

• Psychiatry Physician in Amityville, NY
• Providers in Amityville, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.