Yong R Kim, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

209364 Issued in NY

Practice address

8635 Queens Blvd
Suite1E
Elmhurst, NY 11373-4434

Phone

(718) 205-4544

Fax

(718) 205-5594

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBEDCA
• FHIR API: https://fhir4.healow.com/fhir/r4/EBEDCA/Endpoint/EBEDCA
• Direct secure messaging: kiy9001@direct.nyp.org

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.

• Premier Family Medicine PC

  • Family Medicine Physician
  • Elmhurst, NY
  • NPI 1225228778
  Medicare reassignment NPD Authorized official
• Newyork-Presbyterian/Queens

  • Cardiovascular Disease Physician
  • Flushing, NY
  • NPI 1013960962

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1629067483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 QUEENS BLVD",
            "address_2": "SUITE1E",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734434",
            "telephone_number": "718-205-4544",
            "fax_number": "718-205-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 QUEENS BLVD",
            "address_2": "SUITE1E",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734434",
            "telephone_number": "718-205-4544",
            "fax_number": "718-205-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YONG",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "209364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01897034",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-MEDICARE",
            "identifier": "06378G",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suji Kim
• Sun Ja Kim, NP
• Taeyong Kim, PT
• Vivian Minju Kim, NP
• Woo Suk Kim, DO
• Irina Kimyagar, RDE
• Kinetix Professional Management, Inc.
• Kinetix Professional Management, Inc.
• Victoria C N King, M.S. CCC-SLP
• Kings Optical,Inc

• Family Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.