Individual provider Active NPI

Jin Yi Kim

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1659801132
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341150 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453
Phone
(718) 299-7295
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95006383 CA
Family Nurse Practitioner 363LF0000X F341150 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453

Mailing address

3198 Grand Concourse
Bronx, NY 10458-1000
Phone (718) 618-0401

Other practice location 1

861 Glencliff St Apt 8
LA Habra, CA 90631-1640
Phone (646) 629-3569

Other practice location 2

861 Glencliff St Apt 8
LA Habra, CA 90631-1640
Phone (646) 629-3569

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190501002625 NY Practitioner - Nurse Practitioner 7315289949 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Essen Medical Associates, PCGroup PAC ID 1759353501, 264 clinicians

Practice addresses (Care Compare)

2505 Grand Ave
Bronx, NY 10468-4206
Phone (718) 295-1400

2626 Halperin Ave
FL 1
Bronx, NY 10461-2631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95006383CAMDFamily Nurse Practitioner
F341150NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Urgicare, PLLC CurrentSince Mar 25, 2019 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 25, 2019 Accepting new patients
Essen Medical Associates,PC CurrentSince Mar 25, 2019 Accepting new patients

Locations

2445 Arthur Ave
Bronx, NY 10458
Phone (718) 220-3434

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Networks

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

Interoperability endpoints

  • Direct secure messaging: jinyi.kim@ema.eclinicaldirectplus.com

Organizations & group practices 4

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659801132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581000",
            "telephone_number": "718-618-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-299-7295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "861 Glencliff St Apt 8",
            "address_purpose": "LOCATION",
            "city": "LA Habra",
            "state": "CA",
            "postal_code": "906311640",
            "country_code": "US",
            "telephone_number": "646-629-3569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "861 Glencliff St Apt 8",
            "address_purpose": "LOCATION",
            "city": "LA Habra",
            "state": "CA",
            "postal_code": "906311640",
            "country_code": "US",
            "telephone_number": "646-629-3569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN YI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95006383",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.