Sungkyung Kelly Keum, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F354878 Issued in NY

Practice address

1468 Madison Ave
New York, NY 10029-6508

Phone

(201) 317-8528

NPI assigned

Jun 19, 2025

Last updated

Jun 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icahn School of Medicine at Mount Sinai

  dba Neurosurgery Department of Mount Sinai

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1497029581
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1750278008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 CEDAR AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "201-317-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEUM",
        "first_name": "SUNGKYUNG",
        "middle_name": "KELLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Kettenring
• Falona Ketter
• Caryn Ketteringham, PMHNP
• Michael A Ketteringham, M.D., M.P.H.
• Mary Beth Kettyle, RN
• William Keusch
• Janine Keuskamp, MD
• Kevin E. Smith DDS PC
• Kevin Guo, Medical PC
• Kevin M Troy MD PC

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2025; 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.

Verify at the official NPI Registry.