Active NPI
Min Jeong Kim, O.D.
- Optometrist
- Brooklyn, NY
National Provider Identifier
1750566857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 007148
- Practice address
- 733 Manhattan Ave
Brooklyn, NY 11222-2944 - Phone
- (718) 389-6234
- Fax
- (718) 349-2560
- NPI assigned
- Jan 8, 2008
- Last updated
- Jan 8, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 007148 | NY | Primary |
Addresses
Primary practice location
733 Manhattan Ave
Brooklyn, NY 11222-2944
Mailing address
57-31 256TH Street
Little Neck, NY 11362
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007148 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empire Vision Center, Inc | Current | Accepting new patients | |
| Empire Vision Center Inc | Optometrist | Current | Accepting new patients |
| Greenpoint Optometric Group, PLLC | Optometrist | Past | Accepting new patients |
Locations
25469 Horace Harding Expy
Little Neck, NY 11362
Phone (718) 225-0362
1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200
Organizations & group practices 3
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.
-
- Optometrist
- Brooklyn, NY
- NPI 1124530258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1750566857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57-31 256TH STREET",
"city": "LITTLE NECK",
"state": "NY",
"postal_code": "11362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "733 MANHATTAN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112222944",
"telephone_number": "718-389-6234",
"fax_number": "718-349-2560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MIN",
"middle_name": "JEONG",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "007148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.