Tae Jung Kim

Primary specialty

SpecialistTaxonomy code 174400000X

License

022985 Issued in NY

Practice address

6123 229TH St FL 2
Oakland Gardens, NY 11364-2422

Phone

(718) 886-8180

NPI assigned

Nov 11, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1891949368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520112",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113520112",
            "telephone_number": "718-886-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 229TH ST FL 2",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642422",
            "telephone_number": "718-886-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAE",
        "middle_name": "JUNG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "022985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Eunhae Kim
• Hojung Kim, RPH
• Ji Young Kim
• John Kim, L.AC
• Michael Ethan Kim, D.M.D.
• Yeesoon Kim
• KJ Acu & Herbs Corp.
• KJ Acu & Herbs Corp.
• Sandy Robin Kline, OD
• James Koh, PHARMD

• Specialist in Oakland Gardens, NY
• Providers in Oakland Gardens, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.