Individual provider Active NPI

Jane Kim, MD

  • Anesthesiology Physician
  • Purchase, NY
National Provider Identifier
1669790259
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
274753 Issued in NY
Practice address
3030 Westchester Avenue
Purchase, NY 10577
Phone
(914) 630-5984
NPI assigned
May 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 274753 NY Primary

Addresses

Primary practice location

3030 Westchester Avenue
Purchase, NY 10577

Mailing address

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-6466

Other practice location 1

77 Park Ave
Hoboken, NJ 07030-7105
Phone (646) 621-5613

Other practice location 2

73 Market St
Yonkers, NY 10710-7616
Phone (914) 831-6820

Other identifiers 1

IdentifierTypeStateIssuer
04833161MedicaidNY

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
I20170406001056 NY Practitioner - Anesthesiology 5496977977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
274753NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Mar 1, 2021 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

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

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

3030 Westchester Ave
Purchase, NY 10577
Phone (914) 682-6435

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Interoperability endpoints

  • Direct secure messaging: jakim@hiemail.healtheconnections.org

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": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1669790259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-682-6466",
            "fax_number": "914-681-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 WESTCHESTER AVENUE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "10577",
            "telephone_number": "914-630-5984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070307105",
            "country_code": "US",
            "telephone_number": "646-621-5613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Market St",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107107616",
            "country_code": "US",
            "telephone_number": "914-831-6820",
            "fax_number": "914-831-6821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-07",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "274753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04833161",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

Verify at the official NPI Registry.