Active NPI
Young Ju Kim, C.R.N.A.
- Certified Registered Nurse Anesthetist
- Flushing, NY
National Provider Identifier
1861541666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 228981
- Practice address
- 4500 Parsons Blvd
Flushing, NY 11355-2205 - Phone
- (718) 670-5631
- Fax
- (718) 670-4446
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 228981 | NY | Primary |
Addresses
Primary practice location
4500 Parsons Blvd
Flushing, NY 11355-2205
Mailing address
PO Box 270
Massapequa Park, NY 11762-0270
Phone (631) 264-2035
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pain Management Physicians PLLC | Past | Accepting new patients | |
| Ear, Nose & Throat Associates of New York,P.C. | Past | Accepting new patients |
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.
-
- Facial Plastic Surgery Physician
- Fresh Meadows, NY
- NPI 1124079769
-
- Pain Medicine (Anesthesiology) Physician
- Flushing, NY
- NPI 1417970336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861541666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "117620270",
"telephone_number": "631-264-2035",
"fax_number": "631-264-1418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 PARSONS BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113552205",
"telephone_number": "718-670-5631",
"fax_number": "718-670-4446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YOUNG",
"middle_name": "JU",
"credential": "C.R.N.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NY",
"license": "228981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.