Jay D Kim, DMD, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

058413 Issued in NY

Practice address

119 W 57TH St Ste 914
New York, NY 10019-2401

Phone

(212) 746-5175

NPI assigned

May 25, 2009

Sex

Male

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

DentistAlso: Oral Surgery

Education

JS Weill Medical College, Cornell University, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• MJ Surgeon Group LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Montvale, NJ
  • NPI 1437041225
  NPD Authorized official
• Weill Medical College of Cornell

  • Surgery Physician
  • New York, NY
  • NPI 1669579017
  Medicare reassignment
• Weill Cornell University Medical College

  • Women's Hospital
  • New York, NY
  • NPI 1538141536
  NPD (past)

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

{
    "created_epoch": "1243209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1891920575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST STE 914",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192401",
            "telephone_number": "212-746-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST STE 914",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192401",
            "telephone_number": "212-746-5175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E 68th St",
            "address_2": "F-2132, Dept of Oral & Maxillofacial Surgery",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100654870",
            "country_code": "US",
            "telephone_number": "212-746-5175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-25",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "P69669 LIMITEDPERMIT",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "058413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Ha Eun Kim
• Janet Kim, AU.D.
• Jannet Soowan Kim, NP
• Jason Kim, DPM
• Jason Jeho Kim, MD
• Jeanette Kim, L.AC.
• Jeanyoung Kim, M.D.
• Jennie Kim
• Jennifer Kim
• Jennifer Kim, PA-C

• Oral & Maxillofacial Surgery (D.M.D.) in New York, NY
• Providers in New York, NY by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.
• 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.