Active NPI
Dong Uk Kim, DPM
- Podiatrist
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 006900
- Practice address
- 291 3Rd Ave
New York, NY 10010-5502 - Phone
- (212) 995-1500
- Fax
- (212) 995-1631
- NPI assigned
- Apr 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 006900 | NY | Primary |
Addresses
Primary practice location
291 3Rd Ave
New York, NY 10010-5502
Mailing address
14477 Roosevelt Ave Apt 4D
Flushing, NY 11354-6271
Other practice location 1
5901 69th St
Maspeth, NY 11378-2946
Phone (718) 639-3338
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5901 69TH St
Maspeth, NY 11378-2946
Phone (718) 639-3338
90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050
Hospital & facility affiliations
- Long Island Jewish Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.13 of 100
- Quality
- 72.13
- Promoting interoperability
- 91
- Improvement activities
- 40
- Cost
- 75.81
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 26 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Optum Medical Care, P.C. | Current | Accepting new patients | |
| Optum Urgent Care, PLLC | Current | Accepting new patients | |
| Mount Kisco Medical Group | Past | Accepting new patients |
Locations
555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070
5901 69th St
Maspeth, NY 11378
Phone (718) 639-3338
90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050
110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192
2800 Marcus Ave
Ste 202
New Hyde Park, NY 11042
Phone (516) 216-1777
2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131
2800 Marcus Ave
Ste 207
New Hyde Park, NY 11042
Phone (516) 622-3377
291 3rd Ave
New York, NY 10010
Phone (212) 685-4849
Philadelphia, PA 19195
Interoperability endpoints
- dkim19582@direct.optum.com
Organizations & group practices 4
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.
-
- Cardiovascular Disease Physician
- Mount Kisco, NY
- NPI 1982643003
-
- Urgent Care Clinic/Center
- Jericho, NY
- NPI 1285975797
-
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
- NPI 1053190595
-
- Hematology (Internal Medicine) Physician
- Fishkill, NY
- NPI 1952356362
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Hyde Park, NY
- NPI 1285641514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577923200000",
"number": "1720475890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14477 ROOSEVELT AVE APT 4D",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113546271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 3RD AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100105502",
"telephone_number": "212-995-1500",
"fax_number": "212-995-1631"
}
],
"practiceLocations": [
{
"address_1": "5901 69th St",
"address_purpose": "LOCATION",
"city": "Maspeth",
"state": "NY",
"postal_code": "113782946",
"country_code": "US",
"telephone_number": "718-639-3338",
"fax_number": "718-639-5184",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "DONG",
"middle_name": "UK",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2020-01-02",
"certification_date": "2020-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "006900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.