Individual provider Active NPI

Jin Ah Kim, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1598164113
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
290240 Issued in NY
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-2885
NPI assigned
Aug 19, 2014
Last updated
Nov 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Imaging & Therapy Physician 207UN0902X 290240 NY
Diagnostic Radiology Physician 2085R0202X 290240 NY Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

382 Central Park W Apt 17D
New York, NY 10025-6037
Phone (646) 455-8822

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180531002530 NY Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 0143585711 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Diagnostic Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lenox Hill Radiology and Medical Imaging Associates PCGroup PAC ID 2264424712, 245 clinicians

Practice addresses (Care Compare)

61 E 77TH St
New York, NY 10075-1817
Phone (212) 772-3111

Merit-based Incentive Payment System (MIPS)

Final score
81.08 of 100Reported as group
Quality
62.84
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290240NYMDNuclear Imaging & Therapy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Aug 1, 2021 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 17, 2019 Accepting new patients
Hudson Valley Radiology Associates PLLC Diagnostic Radiology CurrentSince Feb 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Aug 1, 2018 Accepting new patients
Delaware Radiology Associates PA Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 17, 2019 Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology CurrentSince Feb 7, 2022 Accepting new patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Jun 1, 2018 Accepting new patients
Park West Radiology, PC Diagnostic Radiology PastSince Jul 1, 2008 Accepting new patients
Trustees of Columbia University in the City of New York PastSince May 2, 2016 Accepting new patients

Locations

27443 Network Pl
Chicago, IL 60673

9 Bond St
Fl 4
Brooklyn, NY 11201
Phone (718) 222-0202

8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

18 Squadron Blvd
New City, NY 10956
Phone (845) 368-3002

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300

51 W 51st St
Ste 300
New York, NY 10019
Phone (212) 304-6309

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
#4100
New York, NY 10032
Phone (212) 305-5123

1220 Hicksville Rd
Seaford, NY 11783

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 12

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1598164113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 CENTRAL PARK W APT 17D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256037",
            "telephone_number": "646-455-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN AH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "NY",
            "license": "290240",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "290240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.