NPIMap

Organization Active NPI

Martin Sung Kim, O.D., Inc.

  • Optometrist
  • Palisades Park, NJ
National Provider Identifier
1851337703
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00604800 Issued in NJ
Legal business name
MARTIN SUNG KIM, O.D., INC.
Practice address
121 Broad Ave
Palisades Park, NJ 07650-1441
Phone
(201) 346-1500
Fax
(201) 346-1549
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Martin Sung Kim, O.D.NPI 1801827795
Title
President
Phone
(201) 421-9319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OA00604800 NJ Primary

Addresses

Primary practice location

121 Broad Ave
Palisades Park, NJ 07650-1441

Mailing address

333 Grand Ave
#2J
Palisades Park, NJ 07650-1251
Phone (201) 421-9319

Other identifiers 2

IdentifierTypeStateIssuer
02837805MedicaidNY
0129011MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1851337703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GRAND AVE",
            "address_2": "#2J",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501251",
            "telephone_number": "201-421-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501441",
            "telephone_number": "201-346-1500",
            "fax_number": "201-346-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN SUNG KIM, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "SUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-421-9319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00604800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02837805",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129011",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palisades Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.