Bokkyu Kim, PT, PHD

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040603 Issued in NY

Practice address

4000 Medical Center Dr
Ste 108
Fayetteville, NY 13066

Phone

(213) 400-3279

NPI assigned

May 16, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Unity Move Physical Therapy Wellness PLLC

  • Physical Therapy Clinic/Center
  • Fayetteville, NY
  • NPI 1003708892
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1720879729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7282 DABNEY LN",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661823",
            "telephone_number": "213-400-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DR",
            "address_2": "STE 108",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "213-400-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BOKKYU",
        "name_prefix": "Dr.",
        "credential": "PT, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NY",
            "license": "040603",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory G Kenien, MD
• Megan E Kernan, PT, DPT
• Sarah Elizabeth Keyes, AUD
• Sheryl L Khan, RPA
• Kim Green Occupational Therapy, PC
• Ju Yeon Kim
• Brian R Kline, MD
• Chelsea Klock, FNP-C
• Jessica Amanda Knapp, PT
• Robert Joseph Kohlbrenner, PH.D.

• Physical Therapist in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.