Diane Kim

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

101 Hospital Rd
Patchogue, NY 11772-4870

Phone

(631) 654-7100

NPI assigned

Oct 10, 2022

Last updated

Mar 11, 2026By the provider in NPPES

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, NJ2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

City Medical of Upper East Side PLLCGroup PAC ID 0648465039, 658 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

91.79

Promoting interoperability

100

Improvement activities

40

Cost

75.18

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: diane.kim.1@2983.direct.athenahealth.com
• Direct secure messaging: dkim543770@nyumc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New York University

  dba NYU Faculty Group Practice

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group NPD
• City Medical of Upper East Side, PLLC

  dba CityMD Urgent Care

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1801277629
  Medicare reassignment Care Compare group
• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group
• City Medical of Upper East Side, PLLC

  dba CityMD Urgent Care

  • Urgent Care Clinic/Center
  • Smithtown, NY
  • NPI 1043713548
  NPD
• City Medical of Upper East Side, PLLC

  • Urgent Care Clinic/Center
  • New York, NY
  • NPI 1740913763
  NPD
• New York University

  dba NYU Langone Ambulatory Care Chelsea

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

• NYU Langone Hospitals

  dba NYU Langone Hospitals - Suffolk

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Patchogue, NY
  • NPI 1013724061

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  dba NYU Langone Hospital - Suffolk

  • General Acute Care Hospital
  • Patchogue, NY
  • NPI 1831910355
  Care Compare affiliation

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1922723279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 ELTONA PL",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117316012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-654-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Diamond Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Berkeley Heights",
            "state": "NJ",
            "postal_code": "079222104",
            "country_code": "US",
            "telephone_number": "516-783-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00996600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ubaid Khan
• Austin Khorasanchi
• Kristine Marie Kilanowski, RN
• Daphna Kilion, MD
• Carlos Kim
• Jenna Kim
• King Kullen Pharmacies Corp (King Kullen Pharmacy #1)
• King Kullen Pharmacies Corp. (King Kullen Pharmacy)
• King Kullen Pharmacy
• Marlana King

• Physician Assistant in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.