SHK Premier Gastroenterology, PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

216433 Issued in NY

Legal business name

SHK PREMIER GASTROENTEROLOGY, PC

Practice address

5645 Main St
Flushing, NY 11355-5045

Phone

(718) 670-1159

Fax

(718) 670-2456

NPI assigned

Jan 2, 2009

Last updated

Jan 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sang Kim, MDNPI 1033147368

Title

President

Phone

(646) 354-0416

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sang Hoon Kim, M.D.

  • Gastroenterology Physician
  • Flushing, NY
  • NPI 1033147368
  Authorized official Same address or phone

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1538305131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15439 RIVERSIDE DR",
            "city": "BEECHHURST",
            "state": "NY",
            "postal_code": "113571339",
            "telephone_number": "646-354-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-1159",
            "fax_number": "718-670-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHK PREMIER GASTROENTEROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-354-0416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "216433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02728210",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "9255UA",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Inna Shkadron, SP.ED.
• Eliana Shkedy, RD
• Natalie Shlomo, LMSW
• Amy Shluker
• Ilene Shmuel

• Gastroenterology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.