John Kim MD Med & Geriatrics, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JOHN KIM MD MED & GERIATRICS, LLC

Doing business as

John Kim ,MD Internal Medicine & Geriatrics

Practice address

158 Linwood Plaza #324-325
Fort Lee, NJ 07024

Phone

(201) 944-7300

Fax

(201) 944-7311

NPI assigned

Apr 15, 2010

Last updated

Mar 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Soon Kim

Title

Office Manager

Phone

(201) 944-7300

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• John Kim ,MD Internal Medicine & Geriatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Kim, M.D.

  • Internal Medicine Physician
  • Fort Lee, NJ
  • NPI 1659359263
  Medicare reassignment NPD

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1891011854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 LINWOOD PLAZA #324-325",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-944-7300",
            "fax_number": "201-944-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 LINWOOD PLAZA #324-325",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-944-7300",
            "fax_number": "201-944-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KIM MD MED & GERIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-944-7300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA06862000",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7954604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John Kim ,MD Internal Medicine & Geriatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.