Individual provider Active NPI

Eunhyeong Kim

  • Physical Therapist
  • Woodside, NY
National Provider Identifier
1689130767
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
043077-1 Issued in NY
Practice address
6011 39TH Ave Apt 3E
Woodside, NY 11377-2697
Phone
(929) 459-0409
NPI assigned
Feb 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 043077-1 NY Primary

Addresses

Primary practice location

6011 39TH Ave Apt 3E
Woodside, NY 11377-2697

Mailing address

6011 39TH Ave Apt 3E
Woodside, NY 11377-2697
Phone (929) 459-0409

Other names 1

  • Dr. Eunhyeong Lucy Kim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043077NYMDClinical Social Worker
043077-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimized Independence OT PLLC Physical Therapist CurrentSince Jun 17, 2022 Accepting new patients
Montefiore Medical Center PastSince May 3, 2019 Accepting new patients

Organizations & group practices 2

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": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1689130767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 39TH AVE APT 3E",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772697",
            "telephone_number": "929-459-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 39TH AVE APT 3E",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772697",
            "telephone_number": "929-459-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUNHYEONG",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043077-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNHYEONG",
            "last_name": "KIM",
            "middle_name": "LUCY",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.