Individual provider Active NPI

Lydia Kim, L.AC.

  • Acupuncturist
  • Roslyn Heights, NY
National Provider Identifier
1619610672
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
007035-01 Issued in NY
Practice address
216 Willis Ave. Suite 001
Roslyn Heights, NY 11577-2125
Phone
(917) 747-4601
NPI assigned
Apr 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anaplastologist 229N00000X 007035-01 NY
Acupuncturist 171100000X 007035-01 NY Primary

Addresses

Primary practice location

216 Willis Ave. Suite 001
Roslyn Heights, NY 11577-2125

Mailing address

5311 Francis Lewis Blvd
Oakland Gardens, NY 11364-1632

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007035-01NYMDAnaplastologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ju Hua Acupuncture PC Acupuncturist Current Accepting new patients

Locations

216 Willis Ave
Ste 1
Roslyn Hts, NY 11577
Phone (516) 399-2501

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1619610672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 FRANCIS LEWIS BLVD",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113641632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 WILLIS AVE. SUITE 001",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772125",
            "telephone_number": "917-747-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LYDIA",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "229N00000X",
            "taxonomy_group": "",
            "desc": "Anaplastologist",
            "state": "NY",
            "license": "007035-01",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "007035-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.