Individual provider Active NPI

Wun Jung Kim, M.D.

  • Child & Adolescent Psychiatry Physician
  • Piscataway, NJ
National Provider Identifier
1982690525
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
25MA09416600 Issued in NJ
Practice address
671 Hoes LN W Ste 338a
Piscataway, NJ 08854-8021
Phone
(732) 235-7647
Fax
(732) 235-4220
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35048297 OH
Child & Adolescent Psychiatry Physician 2084P0804X 35048297 OH
Child & Adolescent Psychiatry Physician 2084P0804X 25MA09416600 NJ Primary

Addresses

Primary practice location

671 Hoes LN W Ste 338a
Piscataway, NJ 08854-8021

Mailing address

PO Box 829642
Philadelphia, PA 19182-9642
Phone (866) 470-6626

Other practice location 1

3130 Glendale Ave
Kobacker Center
Toledo, OH 43614-5811
Phone (419) 383-3815

Other identifiers 1

IdentifierTypeStateIssuer
0501595MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140407001134 NJ Practitioner - Psychiatry 1254391238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as group
Quality
70.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09416600NJMDChild & Adolescent Psychiatry Physician
35048297OHMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Children'S Specialized Hospital CurrentSince Oct 31, 2016 Accepting new patients
Children' Specialized Hospital CurrentSince Oct 31, 2016 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Psychiatry CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Psychiatry CurrentSince Jan 15, 2014 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
University of Toledo Physicians LLC Psychiatry Past Accepting new patients

Locations

150 New Providence Rd
Mountainside, NJ 07092

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

10 Plum St
New Brunswick, NJ 08901
Phone (732) 235-6333

675 Hoes Ln W
Piscataway, NJ 08854
Phone (732) 235-4402

671 Hoes Ln W
Ste 338A
Piscataway, NJ 08854
Phone (732) 235-7647

3575 Quakerbridge Rd
Trenton, NJ 08619
Phone (609) 631-2800

Interoperability endpoints

  • Direct secure messaging: wkim47912@epicdirect.rwjbh.org

Organizations & group practices 11

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1982690525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 829642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191829642",
            "telephone_number": "866-470-6626",
            "fax_number": "413-599-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 HOES LN W STE 338A",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088548021",
            "telephone_number": "732-235-7647",
            "fax_number": "732-235-4220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3130 Glendale Ave",
            "address_2": "Kobacker Center",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436145811",
            "country_code": "US",
            "telephone_number": "419-383-3815",
            "fax_number": "419-383-3098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "WUN",
        "middle_name": "JUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35048297",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35048297",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA09416600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0501595",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

Verify at the official NPI Registry.