Active NPI
Julia E. Kim, O.D.
- Optometrist
- Palisades Park, NJ
National Provider Identifier
1558524462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV007281-1
- Practice address
- 171 Roosevelt Place
Ground Floor
Palisades Park, NJ 07650 - Phone
- (917) 715-5600
- NPI assigned
- Jul 10, 2008
- Last updated
- Jul 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV007281-1 | NY | Primary |
| Optometrist | 152W00000X | 27OA00615500 | NJ |
Addresses
Primary practice location
171 Roosevelt Place
Ground Floor
Palisades Park, NJ 07650
Mailing address
171 Roosevelt Place
Ground Floor
Palisades Park, NJ 07650
Phone (917) 715-5600
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV007281-1 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Eye Clinic, Inc. | Optometrist | Past | Accepting new patients |
| Martin Sung Kim, O.D., Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Palisades Park, NJ
- NPI 1639301450
-
- Optometrist
- Palisades Park, NJ
- NPI 1851337703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1558524462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 ROOSEVELT PLACE",
"address_2": "GROUND FLOOR",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "07650",
"telephone_number": "917-715-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ROOSEVELT PLACE",
"address_2": "GROUND FLOOR",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "07650",
"telephone_number": "917-715-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JULIA",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-10",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV007281-1",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00615500",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palisades Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.