Active NPI
Jacqueline Kim
- Speech-Language Pathologist
- New York, NY
National Provider Identifier
1801758784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 036268
- Practice address
- 499 W 133Rd St
New York, NY 10027-7404 - Phone
- (347) 450-7444
- NPI assigned
- Nov 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 036268 | NY | Primary |
Addresses
Primary practice location
499 W 133Rd St
New York, NY 10027-7404
Mailing address
499 W 133Rd St
New York, NY 10027-7404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036268 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764374400000",
"number": "1801758784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "499 W 133RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100277404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 W 133RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100277404",
"telephone_number": "347-450-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-11-29",
"last_updated": "2025-11-29",
"certification_date": "2025-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "036268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.