Individual provider Active NPI

Donald D Kim, O.D.

  • Optometrist
  • Flushing, NY
National Provider Identifier
1881698322
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T005484-1 Issued in NY
Practice address
132-15 41St Ave
Suite CC
Flushing, NY 11355-3962
Phone
(718) 358-2010
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00603100 NJ
Optometrist 152W00000X T005484-1 NY Primary

Addresses

Primary practice location

132-15 41St Ave
Suite CC
Flushing, NY 11355-3962

Mailing address

247 Closter Dock Road
Closter, NJ 07624-2619
Phone (201) 564-7700

Other practice location 1

247 Closter Dock Road
Closter, NJ 07624-2619
Phone (201) 564-7700

Other practice location 2

1825 Riverside Dr Apt 1B
New York, NY 10034-5308
Phone (212) 304-2010

Other identifiers 2

IdentifierTypeStateIssuer
01719346MedicaidNY
0172588MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081023000014 NJ Practitioner - Optometry 6204994080 Reassigns benefits to 1 organization
I20101029000009 NY Practitioner - Optometry 6204994080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Sight Medical Doctors PLLCGroup PAC ID 5991935173, 115 clinicians

Practice addresses (Care Compare)

247 Closter Dock Rd
Closter, NJ 07624-2619
Phone (201) 564-7700

260 E Middle Country Rd
Suite 201
Smithtown, NY 11787-2925
Phone (631) 265-8780

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T005484-1NYMDOptometrist
005484NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Eye Surgery, PC CurrentSince Aug 14, 2017 Accepting new patients
Sight Medical Doctors PLLC CurrentSince Nov 14, 2023 Accepting new patients
Closter Eye Care, Inc. Optometrist CurrentSince Jun 1, 2008 Accepting new patients
Sight Medical Doctors PLLC CurrentSince Nov 14, 2023 Accepting new patients
Raymond Fong MD, PC Past Accepting new patients

Locations

247 Closter Dock Rd
Closter, NJ 07624
Phone (201) 564-7700

1200 Waters Pl
Ste 304
Bronx, NY 10461
Phone (718) 518-0060

8340 Woodhaven Blvd
Glendale, NY 11385
Phone (718) 441-0101

125 Kennedy Dr
Ste 400
Hauppauge, NY 11788

1825 Riverside Dr
Apt 1B
New York, NY 10034
Phone (212) 304-2010

260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1881698322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CLOSTER DOCK ROAD",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076242619",
            "telephone_number": "201-564-7700",
            "fax_number": "201-564-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132-15 41ST AVE",
            "address_2": "SUITE CC",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553962",
            "telephone_number": "718-358-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "247 Closter Dock Road",
            "address_purpose": "LOCATION",
            "city": "Closter",
            "state": "NJ",
            "postal_code": "076242619",
            "country_code": "US",
            "telephone_number": "201-564-7700",
            "fax_number": "201-564-7701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 Riverside Dr Apt 1B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100345308",
            "country_code": "US",
            "telephone_number": "212-304-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONALD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00603100",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T005484-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01719346",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172588",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.