Individual provider Active NPI

Minjee Kim

  • Pharmacist
  • Allston, MA
National Provider Identifier
1972320760
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH1000572 Issued in MA
Practice address
465 Cambridge St
Allston, MA 02134-2019
Phone
(617) 257-0104
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH1000572 MA Primary

Addresses

Primary practice location

465 Cambridge St
Allston, MA 02134-2019

Mailing address

465 Cambridge St
Allston, MA 02134-2019

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH1000572MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Sep 29, 2024 Accepting new patients
Walgreen Co PastSince Sep 29, 2024 Accepting new patients

Locations

465 Cambridge St
Allston, MA 02134
Phone (617) 254-0104

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1972320760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 CAMBRIDGE ST",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021342019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 CAMBRIDGE ST",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021342019",
            "telephone_number": "617-257-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINJEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH1000572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.