Individual provider Active NPI

Soonwon Lim, NP-C

  • Family Nurse Practitioner
  • Hicksville, NY
National Provider Identifier
1770982712
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F338121-1 Issued in NY
Practice address
45 McAlester Ave
Hicksville, NY 11801-3719
Phone
(646) 266-1806
NPI assigned
Aug 15, 2014
Last updated
Aug 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F338121-1 NY Primary

Addresses

Primary practice location

45 McAlester Ave
Hicksville, NY 11801-3719

Mailing address

45 McAlester Ave
Hicksville, NY 11801-3719
Phone (646) 266-1806

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
I20180817001260 NY Practitioner - Nurse Practitioner 0244554301 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F338121-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 4, 2018 Accepting new patients
New York University CurrentSince Jul 4, 2018 Accepting new patients
New York University Current Accepting new patients
New York University CurrentSince Dec 1, 2024 Accepting new patients

Locations

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: slim97576@nyumc.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1770982712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MCALESTER AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013719",
            "telephone_number": "646-266-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MCALESTER AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013719",
            "telephone_number": "646-266-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "SOONWON",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338121-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.