Jeongwon Kim, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

230641 Issued in NY

Practice address

1608 Lemoine Ave Ste 206
Fort Lee, NJ 07024-5622

Phone

(917) 301-5821

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT, NJ2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Hackensack, NJ, CCN 317047
• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score

95.41 of 100Reported as group

Quality

83.74

Promoting interoperability

100

Improvement activities

40

Cost

72.88

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Fort Lee Internal Medicine PC

  • Internal Medicine Physician
  • Fort Lee, NJ
  • NPI 1952820623
  Medicare reassignment NPD Authorized official
• Masonicare Behavioral Health, LLC

  • Geriatric Psychiatry Physician
  • Wallingford, CT
  • NPI 1992781488
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys New Jersey LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Hackensack, NJ
  • NPI 1952402737
  Care Compare affiliation
• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1831199199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 LEMOINE AVE STE 206",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245622",
            "telephone_number": "917-301-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 LEMOINE AVE STE 206",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245622",
            "telephone_number": "917-301-5821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 Beach Channel Dr",
            "address_purpose": "LOCATION",
            "city": "Arverne",
            "state": "NY",
            "postal_code": "116921409",
            "country_code": "US",
            "telephone_number": "718-945-7150 x1222",
            "fax_number": "718-945-2596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Cellini Pl Ste 102",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "CT",
            "postal_code": "065161666",
            "country_code": "US",
            "telephone_number": "203-931-2370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONGWON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "42398",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "230641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeongwon.kim@xdr.hhchealthdirect.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Cellini Pl Ste 102",
            "city": "West Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065161666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eunja Kim, M.D.
• Grace Jiae Kim
• Hyun J Kim, L.AC
• Hyung Kim, D.P.T., M.S.O.T
• James Chongho Kim, R.PH
• John Kim, D.C.
• John Kim, M.D.
• John S Kim, M.D.
• Jong Hyun Kim, MD, PHD
• Kate E Kim

• Infectious Disease Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Infectious Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.