Individual provider Active NPI

Anthony C Kim, D.O.

  • Internal Medicine Physician
  • East Meadow, NY
National Provider Identifier
1891718490
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
208533-1 Issued in NY
Practice address
60 Merrick Ave
East Meadow, NY 11554-1578
Phone
(516) 222-9300
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 208533-1 NY Primary

Addresses

Primary practice location

60 Merrick Ave
East Meadow, NY 11554-1578

Mailing address

21 Eagle LN
Roslyn, NY 11576-2501
Phone (516) 458-7127

Other identifiers 1

IdentifierTypeStateIssuer
02091349MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081024000211 NY Practitioner - Internal Medicine 2668530353 Reassigns benefits to 2 organizations
Practice locations: East Meadow, NY; Roslyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2248 31St St
Astoria, NY 11105-2714
Phone (718) 571-9192

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2085331NYMDLicensed Practical Nurse
208533-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Feb 4, 2021 Accepting new patients
City Medical of Upper East Side, PLLC Current Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Nov 22, 2010 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Feb 4, 2021 Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Networks

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

Interoperability endpoints

  • Direct secure messaging: anthony.kim.1@2983.direct.athenahealth.com

Organizations & group practices 4

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1891718490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EAGLE LN",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115762501",
            "telephone_number": "516-458-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERRICK AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541578",
            "telephone_number": "516-222-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANTHONY",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208533-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02091349",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.