Individual provider Active NPI

Paulina Kim, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1568568517
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
240568 Issued in NY
Practice address
220 E 42ND St
New York, NY 10017
Phone
(212) 609-1900
NPI assigned
Sep 16, 2006
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 240568-1 NY
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 240568 NY Primary

Addresses

Primary practice location

220 E 42ND St
New York, NY 10017

Mailing address

220 E 42ND St FL 7
New York, NY 10017-5806
Phone (212) 609-1920

Other identifiers 1

IdentifierTypeStateIssuer
240568-1OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20150127000063 NJ Practitioner - Hospice/Palliative Care 1557550977 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
240568-1NYMDInternal Medicine Physician
240568NYMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 3, 2016 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Internal Medicine CurrentSince Oct 3, 2016 Accepting new patients

Locations

1610 Route 88
Ste 203
Brick, NJ 08724
Phone (732) 268-8470

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1568568517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 42ND ST FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175806",
            "telephone_number": "212-609-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "212-609-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAULINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "240568-1",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "240568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "240568-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.