Active NPI
Joon Kim, PHARM.D.
- Pharmacist
- New York, NY
National Provider Identifier
1811201783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 063796
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 063796 | NY | MD | Clinical Social Worker |
| 28RI03335600 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vital Pharmacy Group, Inc. | Current | 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.
-
- Community/Retail Pharmacy
- New York, NY
- NPI 1295575728
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1962842690
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1558864702
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.