Individual provider Active NPI

Joon Kim, PHARM.D.

  • Pharmacist
  • New York, NY
National Provider Identifier
1811201783
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063796 Issued in NY
Practice address
4520 Broadway
New York, NY 10040-4900
Phone
(917) 388-3129
Fax
(917) 388-3184
NPI assigned
Aug 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03335600 NJ
Pharmacist 183500000X 063796 NY Primary

Addresses

Primary practice location

4520 Broadway
New York, NY 10040-4900

Mailing address

4971 Broadway
New York, NY 10034-1651
Phone (917) 388-2622

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
063796NYMDClinical Social Worker
28RI03335600NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Pharmacy Group, Inc. CurrentSince Jul 22, 2025 Accepting new patients
3110 Cuidamed Pharmacy Inc. Past Accepting new patients
Cuidamed RX Inc. Past Accepting new patients

Locations

4971 Broadway
New York, NY 10034
Phone (917) 388-2622

Organizations & group practices 3

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1811201783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341651",
            "telephone_number": "917-388-2622",
            "fax_number": "917-388-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100404900",
            "telephone_number": "917-388-3129",
            "fax_number": "917-388-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOON",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03335600",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063796",
            "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 Jul 17, 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.

Verify at the official NPI Registry.