Janet Jayon Kim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

238148 Issued in NY

Practice address

2079 Forest Ave
Staten Island, NY 10303-1735

Phone

(718) 815-6560

NPI assigned

Feb 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

New York University Medical College - NLG, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Christian Community Health Center IncGroup PAC ID 7719078856, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: janet.kim.1@20119.direct.athenahealth.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Beacon Christian Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1750700902

  W-2 Managing Employee

  CMS ownership
• Beacon Christian Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1639246358

  W-2 Managing Employee

  CMS ownership

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.

• Beacon Christian Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1639246358

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Beacon Christian Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Staten Island, NY
  • NPI 1750700902
  NPD

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483142400000",
    "number": "1891769113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031865",
            "telephone_number": "917-348-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031735",
            "telephone_number": "718-815-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANET",
        "middle_name": "JAYON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "238148",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "238148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Kim, PA-C
• Eugene Kim
• Eun Jung Kim, PHARM.D
• Heejong Joyce Kim, RPH
• Helen Hyosun Kim, MD
• Jasmine Kim
• Junghyun Kim
• Kenneth Kim, RN
• Kyung Sook Kim, FNP
• Minah Kim, DDS

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.