NPIMap

Individual provider Active NPI

Eunyoung Kim

  • Family Nurse Practitioner
  • Forest Hills, NY
National Provider Identifier
1912455890
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340350 Issued in NY
Practice address
9610 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone
(718) 459-0400
Fax
(718) 670-6479
NPI assigned
Sep 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340350 NY Primary

Addresses

Primary practice location

9610 Metropolitan Ave
Forest Hills, NY 11375-6625

Mailing address

55 Water St
2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170106000705 NY Practitioner - Nurse Practitioner 6608157623 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

6 Medical Park Dr
Malta, NY 12020-5051
Phone (518) 289-2717

79 N St
Granville Medical Center
Granville, NY 12832-1137
Phone (518) 642-0612

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F340350NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Glens Falls Hospital Inc. CurrentSince Dec 1, 2022 Accepting new patients
Saratoga Hospital CurrentSince Jul 8, 2022 Accepting new patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Jul 8, 2022 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Feb 1, 2021 Accepting new patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Glens Falls Hospital Inc CurrentSince Dec 1, 2022 Accepting new patients

Locations

9610 Metropolitan Ave
Forest Hills, NY 11375
Phone (718) 459-0400

10837 71st Ave
Ste 2
Forest Hills, NY 11375
Phone (718) 575-8787

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

79 North St
Granville, NY 12832
Phone (518) 642-0612

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

6 Medical Park Dr
Malta, NY 12020
Phone (518) 289-2020

55 Water St
Fl 2
New York, NY 10041

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

3 Care Ln
Ste 300
Saratoga Springs, NY 12866
Phone (518) 226-6000

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

260 W Sunrise Hwy
Valley Stream, NY 11581
Phone (516) 791-4600

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
  • Direct secure messaging: ekim99510@albanymed.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1912455890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 METROPOLITAN AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756625",
            "telephone_number": "718-459-0400",
            "fax_number": "718-670-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUNYOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.