Soonkyum Kim, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA40076 Issued in NJ

Practice address

230 West Jersey St Ste 102
Elizabeth, NJ 07202

Phone

(908) 352-8383

NPI assigned

Aug 2, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942217617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WEST JERSEY ST STE 102",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07202",
            "telephone_number": "908-352-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WEST JERSEY ST STE 102",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07202",
            "telephone_number": "908-352-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOONKYUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA40076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3945600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Khoury
• Dheeraj Khurana
• Hyoeun Kim, PHARMD
• Hyungwook Kim, L.AC
• Sarah Fronhofer Kim, MSW
• Samuel Barnard King Jr., STUDENT MSW/MPH
• Stacy King
• Mark Steven Kirk, DC
• Christopher Kishun, PA-C
• Klein & Scannapiego, MD., PA

• Pediatrics Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.