Myungduk Roger Kim, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

178690 Issued in NY

Practice address

1 Brookdale PLZ
Room 244
Brooklyn, NY 11212-3139

Phone

(718) 240-5668

Fax

(718) 240-6513

NPI assigned

Jun 8, 2006

Last updated

Dec 20, 2013By 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 2

Addresses

Other identifiers 1

Other names 1

• Roger Kim Professional name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Pediatric Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• Interfaith Professional Physician Services, P.C.

  dba OBH Physician Associates

  • Surgery Physician
  • Brooklyn, NY
  • NPI 1457643991

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1720028772
  Medicare reassignment NPD
• Interfaith Emergency Medicine, P.C.

  dba OBH Emergency Medicine Physicians

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1457643785
  NPD
• The Brookdale Hospital Medical Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1639756406
  NPD
• Brookdale Family Care Center, Inc.

  dba BFCC Flatbush

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1962459644

  Pediatrics

  NPD (past)
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1346380870
  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1942241518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLAZA, STRAUSBERG SUITE 244",
            "address_2": "BROOKDALE UNIVERSITY HOSPITAL AND MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11212",
            "telephone_number": "718-240-5628",
            "fax_number": "718-240-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "address_2": "ROOM 244",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5668",
            "fax_number": "718-240-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MYUNGDUK",
        "middle_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "178690",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "178690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01404448",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROGER",
            "last_name": "KIM",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Min Ji Kim
• Mina Kim, O.D.
• Minjae Kim, MD
• Myung Hwa Kim, NP
• Myung-Rho Kim, DO
• Nami Kim
• Nari Kim
• Nathan Kim, MD
• Rebecca S Kim, LCSW
• Richard Kim

• Neonatal-Perinatal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.