Il Jin Kim, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV008772 Issued in NY

Practice address

90 W 225TH St
Bronx, NY 10463-7002

Phone

(718) 664-2164

NPI assigned

Jul 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Visual Optometry PLLC

  • Optometrist
  • Brooklyn, NY
  • NPI 1871351155
  Medicare reassignment NPD
• Wise Medical Ny PC

  • Optometrist
  • Brooklyn, NY
  • NPI 1245751882
  Medicare reassignment NPD
• National Vision, Inc.

  • Optician
  • Bronx, NY
  • NPI 1750879169
  NPD (past)

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1831685429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8638 TOWN AND COUNTRY BLVD APT B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210432906",
            "telephone_number": "443-765-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W 225TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104637002",
            "telephone_number": "718-664-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "IL JIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Kim
• Hansea Kim, M.D.
• Hyesung Kim, RN
• Hyesung Kim, MD
• Hyunji Kim
• Injun Kim
• Ja Hyun Kim
• Jaehyun Kim, MD
• James Chan Kim, PHARMD
• Jamie Kim, MD

• Optometrist in Bronx, NY
• Providers in Bronx, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.