KS Podiatry PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

N006264 Issued in NY

Legal business name

KS PODIATRY PC

Practice address

21909 Northern Blvd
Bayside, NY 11361-3525

Phone

(718) 229-9200

Fax

(866) 668-7533

NPI assigned

Mar 30, 2013

Organization subpart

No

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

Authorized official

Name

Kwangsu Kim, DPMNPI 1104095744

Title

President

Phone

(718) 229-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kwangsu Kim, DPM

  • Podiatrist
  • Bayside, NY
  • NPI 1104095744

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1710220561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034906",
            "telephone_number": "718-229-9200",
            "fax_number": "866-668-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21909 NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613525",
            "telephone_number": "718-229-9200",
            "fax_number": "866-668-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KS PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-30",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KWANGSU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-229-9200",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly M Kresofsky, M.A., CCC-SLP
• Joel Edmond Kronberg, DDS
• Jonathan Kruger
• Stephen Robert Kruger, D.D.S.
• Jeffrey Krupen, M.D.
• Daniel Alexander Kuncio, DDS
• Zenovia Didoshak Kuncio, DDS
• Won Seok Kwag
• Kwon Podiatry PC
• Hanna Kwon

• Foot & Ankle Surgery Podiatrist in Bayside, NY
• Providers in Bayside, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.