Individual provider Active NPI

Anthony Junghoi Kim, M.D.

  • Clinical & Laboratory Immunology (Internal Medicine) Physician
  • Hackensack, NJ
National Provider Identifier
1790048254
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Immunology (Internal Medicine) PhysicianTaxonomy code 207RI0001X
License
25MA09684900 Issued in NJ
Practice address
92 Summit Ave
Hackensack, NJ 07601-1263
Phone
(201) 342-0066
NPI assigned
Jun 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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
Clinical & Laboratory Immunology (Internal Medicine) Physician 207RI0001X 25MA09684900 NJ Primary

Addresses

Primary practice location

92 Summit Ave
Hackensack, NJ 07601-1263

Mailing address

92 Summit Ave
Hackensack, NJ 07601-1263

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921000285 NJ Practitioner - Internal Medicine 9335456565 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

350 Engle S
5TH FL Room 5518
Englewood, NJ 07631-1808
Phone (201) 568-5250

350 Engle St
Englewood, NJ 07631-1808

350 Engle St Main
Suite 256
Englewood, NJ 07631-1808
Phone (201) 894-3364

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Jan 14, 2017 Accepting new patients
St Josephs Medical Group PC CurrentSince Mar 1, 2022 Accepting new patients
St. Joseph'S Healthcare, Inc. CurrentSince Dec 15, 2021 Accepting new patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. CurrentSince Dec 14, 2016 Accepting new patients
Cogent Healthcare of New Jersey, PC CurrentSince Dec 14, 2016 Accepting new patients
Englewood Hospital and Medical Center Past Accepting new patients

Locations

350 Engle St
#2N
Englewood, NJ 07631
Phone (201) 894-3414

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
#P
Paterson, NJ 07503

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

Organizations & group practices 6

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 1

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1790048254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011263",
            "telephone_number": "201-342-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANTHONY",
        "middle_name": "JUNGHOI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "NJ",
            "license": "25MA09684900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.