Dongsoo Kim, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

165345 Issued in NY

Practice address

102 Valentine St
Mount Vernon, NY 10550-2504

Phone

(914) 665-2267

Fax

(914) 693-7801

NPI assigned

Jun 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1881622504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARDEN DR",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105302936",
            "telephone_number": "914-693-8122",
            "fax_number": "914-693-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 VALENTINE ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502504",
            "telephone_number": "914-665-2267",
            "fax_number": "914-693-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONGSOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "165345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01709291",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rafeeza Khan, PHARMD
• Zareen R Khan, MD
• Andrea Kidd, M.A., CCC-SLP
• Stephen Bruce Kildare, PSYD
• Chung Eun P Kim, M.D.
• Elizabeth Kim
• Kyung H Kim, M.D
• Tai Ho Kim, R.PH.
• Kindness Home Care LLC
• Simonique King

• Nephrology Physician in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2026; 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.