Minsoo Kim, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

082555-1 Issued in NY

Practice address

7925 Winchester Blvd BLDG 40
Queens Village, NY 11427-2128

Phone

(718) 464-7500

NPI assigned

Oct 22, 2010

Last updated

Apr 6, 2022By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1902106024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD BLDG 40",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-464-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD BLDG 40",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-464-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8114 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113733789",
            "country_code": "US",
            "telephone_number": "718-899-9810 x217",
            "fax_number": "718-899-9699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINSOO",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-22",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082555-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KHS Pharmacy Inc (County Pharmacy)
• Kids Pride Pediatrics, PC
• Gahyun Kim
• Jabez Kim
• Joe Young Kim, MSED.
• Florence King-Inneh, RN
• Donna King
• Sandra Elizabeth King
• Janice Kingston, LPN
• Kiss Agency

• Clinical Social Worker in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.