Individual provider Active NPI

Yeji Kim, D.O.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1831585652
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
299021 Issued in NY
Practice address
1 Park Ave FL 7
New York, NY 10016-5818
Phone
(646) 754-5079
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 299021 NY Primary

Addresses

Primary practice location

1 Park Ave FL 7
New York, NY 10016-5818

Mailing address

450 Clarkson Ave
Department of Psychiatry- Box 1203
Brooklyn, NY 11203-2012
Phone (718) 270-2902

Other practice location 1

450 Clarkson Ave
Department of Psychiatry- Box 1203
Brooklyn, NY 11203-2012
Phone (718) 270-2902

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ykim299477@nyumc.direct-ci.com

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
I20210819001883 NY Practitioner - Psychiatry 1153668280 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2021 Accepting new patients
New York University CurrentSince Jul 1, 2021 Accepting new patients

Locations

1 Park Ave
Fl 7
New York, NY 10016
Phone (646) 754-5000

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Organizations & group practices 2

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1831585652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "DEPARTMENT OF PSYCHIATRY- BOX 1203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165818",
            "telephone_number": "646-754-5079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_2": "Department of Psychiatry- Box 1203",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-2902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEJI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "299021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ykim299477@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1 Park Ave Fl 7",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100165818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.