Active NPI
Eunice Kim, PA-C
- Physician Assistant
- New York, NY
National Provider Identifier
1831728328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 025350
- Practice address
- 171 E 65TH St
New York, NY 10065-6607 - Phone
- (212) 223-1025
- NPI assigned
- Apr 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 025350 | NY | Primary |
Addresses
Primary practice location
171 E 65TH St
New York, NY 10065-6607
Mailing address
171 E 65TH St
New York, NY 10065-6607
Phone (212) 223-1025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025350 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1831728328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 E 65TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656607",
"telephone_number": "212-223-1025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 E 65TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656607",
"telephone_number": "212-223-1025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "EUNICE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-06",
"last_updated": "2022-06-14",
"certification_date": "2020-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "025350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.