NPIMap

Individual provider Active NPI

Sung Uk Kim, MD

  • Diagnostic Radiology Physician
  • Flushing, NY
National Provider Identifier
1932118973
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
105860 Issued in NY
Practice address
13656 39TH Ave
Flushing, NY 11354-5508
Phone
(646) 450-7345
Fax
(888) 388-5171
NPI assigned
Aug 7, 2006
Last updated
Dec 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 105860 NY Primary

Addresses

Primary practice location

13656 39TH Ave
Flushing, NY 11354-5508

Mailing address

13656 39TH Ave
Flushing, NY 11354-5508
Phone (646) 450-7345

Other identifiers 1

IdentifierTypeStateIssuer
00185382MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
105860NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Magnetic Resonance Imaging, PC Diagnostic Radiology Past Accepting new patients
Advanced MRI, PC - Raytel Medical Imaging-Bronx Past Accepting new patients
Little Neck Radiology, P.C. Diagnostic Radiology PastSince Dec 19, 1996 Accepting new patients
Radiology of New York P.C. Diagnostic Radiology PastSince Sep 1, 2009 Accepting new patients
Doshi Diagnostic Imaging Services PC Diagnostic Radiology PastSince Jan 1, 2012 Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology PastSince Dec 1, 2015 Accepting new patients
Queens Long Island Medical Group, P.C. Past Accepting new patients
Adel Physical Therapy PC Past Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1932118973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13656 39TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545508",
            "telephone_number": "646-450-7345",
            "fax_number": "888-388-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13656 39TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545508",
            "telephone_number": "646-450-7345",
            "fax_number": "888-388-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUNG",
        "middle_name": "UK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "105860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00185382",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.