Individual provider Active NPI

Heeryoung Kim, MD

  • Psychiatry Physician
  • Bridgeport, CT
National Provider Identifier
1639673403
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
69467 Issued in CT
Practice address
1000 Lafayette Blvd
Bridgeport, CT 06604-4725
Phone
(833) 351-8255
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 69467 CT Primary

Addresses

Primary practice location

1000 Lafayette Blvd
Bridgeport, CT 06604-4725

Mailing address

109 W 27TH St RM 5S
New York, NY 10001-6208

Other practice location 1

109 W 27th St Rm 5S
New York, NY 10001-6208
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220829003757 CT Practitioner - Psychiatry 8527319490 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in New Orleans, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians
Middlesex HospitalGroup PAC ID 5092611731, shared by 7 NPIs, 231 clinicians

Practice addresses (Care Compare)

1000 Lafayette Blvd
Bridgeport, CT 06604-4725
Phone (833) 351-8255

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-6760

90 S Main St
Middletown, CT 06457-3649
Phone (860) 358-3401

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69467CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Pathology Group PC Current Accepting new patients
Middlesex Hospital Psychiatry CurrentSince Sep 1, 2022 Accepting new patients
Middlesex Hospital CurrentSince Sep 1, 2022 Accepting new patients
Middlesex Hospital CurrentSince Sep 1, 2022 Accepting new patients

Locations

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

1250 Boston Post Rd
Old Saybrook, CT 06475
Phone (860) 388-1495

Interoperability endpoints

  • Direct secure messaging: hkim76414@middlesexhealthprd.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1639673403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAFAYETTE BLVD",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044725",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W 27th St Rm 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100016208",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEERYOUNG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "69467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.