Active NPI
Young Sook Kim, M.D.
- Radiation Oncology Physician
- Tappan, NY
National Provider Identifier
1982641742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 25MA04569000
- Practice address
- 33 Claudia CT
Tappan, NY 10983-1936 - Phone
- (845) 359-0289
- Fax
- (845) 359-3241
- NPI assigned
- Jun 1, 2006
- Last updated
- Mar 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 25MA04569000 | NJ | Primary |
| Radiation Oncology Physician | 2085R0001X | 1530801 | NY |
Addresses
Primary practice location
33 Claudia CT
Tappan, NY 10983-1936
Mailing address
33 Claudia CT
Tappan, NY 10983-1936
Phone (845) 359-0289
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8791503 | Medicaid | NJ | |
| 01440784 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1530801 | NY | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catskill Radiation Oncology Consultants, PLLC | Radiation Oncology | Past | Accepting new patients |
Interoperability endpoints
- young.kim@direct.hvhc.org
Organizations & group practices 1
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.
-
- Radiation Oncology Physician
- Middletown, NY
- NPI 1922052315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458345600000",
"number": "1982641742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 CLAUDIA CT",
"city": "TAPPAN",
"state": "NY",
"postal_code": "109831936",
"telephone_number": "845-359-0289",
"fax_number": "845-359-3241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 CLAUDIA CT",
"city": "TAPPAN",
"state": "NY",
"postal_code": "109831936",
"telephone_number": "845-359-0289",
"fax_number": "845-359-3241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YOUNG",
"middle_name": "SOOK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2016-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NJ",
"license": "25MA04569000",
"primary": true
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "NY",
"license": "1530801",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8791503",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01440784",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tappan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.