NPIMap

Individual provider Active NPI

Cecilia Kim, DO

  • Anesthesiology Physician
  • Camp Pendleton, CA
National Provider Identifier
1861807281
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
322944 Issued in NY
Practice address
200 Mercy Circle
Medical Staff Services
Camp Pendleton, CA 92055
Phone
(760) 719-3675
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 322944 NY Primary

Addresses

Primary practice location

200 Mercy Circle
Medical Staff Services
Camp Pendleton, CA 92055

Mailing address

61 Pond LN
Levittown, NY 11756-1146
Phone (646) 427-3812

Other practice location 1

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3000

Other names 1

  • Dr. Cecilia Kim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230828001624 NY Practitioner - Anesthesiology 0648633479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

Hospital & facility affiliations

  • St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322944NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jun 26, 2023 Accepting new patients
New York University CurrentSince Jan 1, 2026 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

Networks

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

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1861807281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 POND LN",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561146",
            "telephone_number": "646-427-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-719-3675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "NY",
            "postal_code": "115721551",
            "country_code": "US",
            "telephone_number": "516-632-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "322944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILIA",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Camp Pendleton, CA

Sources for this page

Verify at the official NPI Registry.