Back Kyun Kim, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

202578 Issued in NY

Practice address

13668 Roosevelt Ave
Flushing, NY 11354-5510

Phone

(718) 997-9000

Fax

(718) 997-8880

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back Kim MD PC Dba Heartvein Nyc

  dba DBA Heartvein NYC

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1326368630
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1699833327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13620 38TH AVE",
            "address_2": "SUITE 8J",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544277",
            "telephone_number": "718-997-9000",
            "fax_number": "718-997-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13668 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545510",
            "telephone_number": "718-997-9000",
            "fax_number": "718-997-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BACK",
        "middle_name": "KYUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "202578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01753162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence B Kilo
• Andrew Hyun Kyu Kim, DO
• Andrew S Kim, M.D.
• Angelina Sunghee Kim, MD
• Angie Y Kim, DMD
• Baekbong Kim, MSW
• Bong Song Kim, M.D.
• Bora V Kim, D.O.
• Bryan S Kim, DMD
• Carey Kim, M.D.

• Cardiovascular Disease Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.