Individual provider Active NPI

Joel Kim

  • Physical Therapist
  • Bloomfield, NJ
National Provider Identifier
1821851197
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02229700 Issued in NJ
Practice address
557 Broad St
Bloomfield, NJ 07003-2885
Phone
(973) 404-7067
NPI assigned
Jan 31, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02229700 NJ Primary

Addresses

Primary practice location

557 Broad St
Bloomfield, NJ 07003-2885

Mailing address

235 Grantwood Blvd
Palisades Park, NJ 07650-1925
Phone (201) 739-5431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226001649 NJ Practitioner - Physical Therapist in Private Practice 1456796887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

1225 Stuyvesant Ave
Union, NJ 07083-3837
Phone (908) 357-1655

211 Berdan Ave
Wayne, NJ 07470-3236
Phone (201) 249-6930

266 Harristown Rd
Suite 200
Glen Rock, NJ 07452-3354
Phone (201) 445-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Physical Therapist CurrentSince Feb 8, 2024 Accepting new patients

Locations

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

Organizations & group practices 1

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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1821851197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 GRANTWOOD BLVD",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501925",
            "telephone_number": "201-739-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032885",
            "telephone_number": "973-404-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-31",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02229700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.