Individual provider Active NPI

David Kim

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1760978050
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F404401 Issued in NY
Practice address
1050 Niagara St
Buffalo, NY 14213-2001
Phone
(716) 507-9134
NPI assigned
Jul 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 656210 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F404401 NY Primary

Addresses

Primary practice location

1050 Niagara St
Buffalo, NY 14213-2001

Mailing address

1050 Niagara St
Buffalo, NY 14213-2001
Phone (716) 507-9134

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230414001071 NY Practitioner - Nurse Practitioner 6901271477 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
East Point Medical PCGroup PAC ID 0749690741, 24 clinicians

Practice addresses (Care Compare)

7116 Grand Ave
Maspeth, NY 11378-1823
Phone (718) 307-1577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
656210NYMDRegistered Nurse
F404401NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Mental Health Services Inc CurrentSince Mar 1, 2023 Accepting new patients
Psychiatric Nurse Practitioner P.C Psychiatric/Mental Health CurrentSince Apr 25, 2024 Accepting new patients
East Point Medical PC Psychiatric/Mental Health CurrentSince Sep 18, 2025 Accepting new patients
Mid-Erie Counseling and Treatment Services Past Accepting new patients

Locations

1526 Walden Ave
Cheektowaga, NY 14225
Phone (716) 895-7167

1526 Walden Ave
Ste 400
Cheektowaga, NY 14225
Phone (716) 895-7167

7116 Grand Ave
Maspeth, NY 11378
Phone (718) 307-1577

245 5th Ave
Fl 3
New York, NY 10016
Phone (212) 302-4399

Interoperability endpoints

  • Direct secure messaging: david.kim@549960591081476.direct.elationemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1760978050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132001",
            "telephone_number": "716-507-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132001",
            "telephone_number": "716-507-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "656210",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.