NPIMap

Individual provider Active NPI

Yunki Kim

  • Physician Assistant
  • Fairfield, CT
National Provider Identifier
1760260376
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5151 Park Ave
Fairfield, CT 06825-1090
Phone
(203) 371-7999
NPI assigned
Sep 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5151 Park Ave
Fairfield, CT 06825-1090

Mailing address

5151 Park Ave
Fairfield, CT 06825-1090
Phone (203) 371-7999

Other names 1

  • Mr. Sammy Kim Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240322000355 CT Practitioner - Physician Assistant 5395182604 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians
Hartford HospitalGroup PAC ID 2567366016, 1,040 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

80 Seymour St
Hartford, CT 06102-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jul 15, 2025 Accepting new patients
Midstate Medical Center CurrentSince Mar 1, 2024 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Mar 1, 2024 Accepting new patients
Hartford Hospital CurrentSince Mar 1, 2024 Accepting new patients
William W Backus Hospital CurrentSince Mar 1, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jul 15, 2025 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Mar 1, 2024 Accepting new patients

Locations

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: yunki.kim@xdr.hhchealthdirect.org

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1760260376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 PARK AVE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251090",
            "telephone_number": "203-371-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 PARK AVE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251090",
            "telephone_number": "203-371-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YUNKI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMMY",
            "last_name": "KIM",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.