Individual provider Active NPI

Yesul Tina Kim, MD

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1811525355
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
313819 Issued in NY
Practice address
920 48TH St
Brooklyn, NY 11219-2918
Phone
(718) 283-7800
Fax
(718) 635-7147
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 313819 NY Primary

Addresses

Primary practice location

920 48TH St
Brooklyn, NY 11219-2918

Mailing address

920 48TH St
Brooklyn, NY 11219-2918
Phone (718) 283-7800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617000761 NY Practitioner - Psychiatry 1254874456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at Houston, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maimonides Department of Psychiatry FPPGroup PAC ID 0042115487, 34 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-8165

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Department of Psychiatry FPP Psychiatry CurrentSince Jul 29, 2024 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jul 29, 2024 Accepting new patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients
MMC OB-GYN Faculty Practice Plan Past Accepting new patients

Locations

920 48th St
Brooklyn, NY 11219
Phone (718) 283-7800

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1811525355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192918",
            "telephone_number": "718-283-7800",
            "fax_number": "718-635-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192918",
            "telephone_number": "718-283-7800",
            "fax_number": "718-635-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YESUL",
        "middle_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "313819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.