Active NPI
Bong Song Kim, M.D.
- Radiation Oncology Physician
- Flushing, NY
National Provider Identifier
1740223197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 115195
- Practice address
- 4020 Main St
4TH FL.
Flushing, NY 11354-5519 - Phone
- (347) 532-2888
- NPI assigned
- Jun 14, 2006
- 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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 115195 | NY | Primary |
Addresses
Primary practice location
4020 Main St
4TH FL.
Flushing, NY 11354-5519
Mailing address
4020 Main St
4TH FL.
Flushing, NY 11354-5519
Phone (347) 532-2888
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01026053 | Medicaid | NY | |
| 4592944 | Other | NY | AETNA |
| 913151 | Other | NY | EMPIRE B/C B/S |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franklin Hospital Radiology | Past | Accepting new patients | |
| Manhattan Radiation Oncology PLLC | Past | Accepting new patients | |
| Franklin Hospital | Past | Accepting new patients | |
| South Shore Radiation Oncology Associates P C | Radiation Oncology | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Valley Stream, NY
- NPI 1528075108
-
- Diagnostic Radiology Physician
- Valley Stream, NY
- NPI 1184713109
-
- Radiation Oncology Clinic/Center
- New York, NY
- NPI 1013255041
-
- Radiation Oncology Physician
- Oceanside, NY
- NPI 1801896998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462233600000",
"number": "1740223197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 MAIN ST",
"address_2": "4TH FL.",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545519",
"telephone_number": "347-532-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 MAIN ST",
"address_2": "4TH FL.",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545519",
"telephone_number": "347-532-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BONG SONG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2016-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NY",
"license": "115195",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01026053",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4592944",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE B/C B/S",
"identifier": "913151",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.