Individual provider Active NPI

Tiffany Kyoung Jin Min, AGACNP-BC

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1699497719
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
432445 Issued in NY
Practice address
1283 York Ave 9TH Floor
New York, NY 10065
Phone
(646) 962-4000
NPI assigned
Sep 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 432445 NY Primary

Addresses

Primary practice location

1283 York Ave 9TH Floor
New York, NY 10065

Mailing address

1283 York Ave
Floor 9
New York, NY 10065
Phone (646) 962-4463

Other practice location 1

100 E 77th St
New York, NY 10075-1850
Phone (212) 434-2000

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
I20230214000050 NY Practitioner - Nurse Practitioner 8426420845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-4158

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jul 3, 2023 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 3, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 5, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince Nov 5, 2022 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

170 William St
New York, NY 10038
Phone (212) 238-0100

525 E 68th St
Rm J314
New York, NY 10065
Phone (212) 746-4158

525 E 68th St
#J314
New York, NY 10065
Phone (212) 746-4158

156 William St
Fl 6
New York, NY 10038
Phone (646) 962-2620

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: tim9064@direct.nyp.org

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 5

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": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1699497719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 YORK AVE",
            "address_2": "FLOOR 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "646-962-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 YORK AVE 9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "646-962-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E 77th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751850",
            "country_code": "US",
            "telephone_number": "212-434-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIN",
        "first_name": "TIFFANY",
        "middle_name": "KYOUNG JIN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.