Active NPI
Soomin Robert Kim, PHARM. D.
- Pharmacist
- Paramus, NJ
National Provider Identifier
1992019657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17784
- Practice address
- 224 E Rte 4
Paramus, NJ 07652-5119 - Phone
- (201) 291-4190
- Fax
- (201) 291-4192
- NPI assigned
- Aug 4, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03136700 | NJ | |
| Pharmacist | 183500000X | 17784 | MD | Primary |
Addresses
Primary practice location
224 E Rte 4
Paramus, NJ 07652-5119
Mailing address
224 E Rte 4
Paramus, NJ 07652-5119
Phone (201) 291-4190
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17784 | MD | MD | Pharmacist |
| 28RI03136700 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glass Gardens Inc | Past | Accepting new patients | |
| Glass Gardens Inc. | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Rochelle Park, NJ
- NPI 1942315726
-
- Community/Retail Pharmacy
- Paramus, NJ
- NPI 1639284417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1992019657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 E RTE 4",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076525119",
"telephone_number": "201-291-4190",
"fax_number": "201-291-4192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 E RTE 4",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076525119",
"telephone_number": "201-291-4190",
"fax_number": "201-291-4192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SOOMIN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-04",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03136700",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "17784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.