Individual provider Active NPI

Changsoo Rhim, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1700910825
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
218950 Issued in NY
Practice address
3134 E Tremont Ave
Bronx, NY 10461-5706
Phone
(718) 239-1000
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 218950 NY Primary

Addresses

Primary practice location

3134 E Tremont Ave
Bronx, NY 10461-5706

Mailing address

331 Pacific St
Apt.3
Brooklyn, NY 11201-6335
Phone (917) 572-5872

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
I20130801000058 NY Practitioner - Internal Medicine 2668613795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
218950NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Oct 28, 2024 Accepting new patients
Joseph P. Addabbo Family Health Center, Inc. Current Accepting new patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Oct 28, 2024 Accepting new patients
Joseph P. Addabbo Family Health Center, Inc. CurrentSince Mar 10, 2019 Accepting new patients
Joseph P. Addabbo Family Health Center, Inc. CurrentSince Mar 10, 2019 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. Past Accepting new patients

Locations

6200 Beach Channel Dr
Fl 3
Arverne, NY 11692
Phone (929) 995-0733

6200 Beach Channel Dr
Arverne, NY 11692
Phone (718) 945-2400

120 Richards St
Brooklyn, NY 11231
Phone (718) 834-8202

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

30 S Broadway
Fl 2
Yonkers, NY 10701
Phone (914) 968-4898

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Organizations & group practices 6

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1700910825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 PACIFIC ST",
            "address_2": "APT.3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016335",
            "telephone_number": "917-572-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615706",
            "telephone_number": "718-239-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHIM",
        "first_name": "CHANGSOO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "218950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.