Moonyang Kim, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

115199 Issued in NY

Practice address

10012 101 Avenue
Ozone Park, NY 11416

Phone

(718) 484-6790

Fax

(718) 848-4504

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Complete Heart and Vascular Care PC

  • Interventional Cardiology Physician
  • Brooklyn, NY
  • NPI 1679148464
  NPD (past)
• Sharad Soni Physician P.C.

  • Internal Medicine Physician
  • Ozone Park, NY
  • NPI 1457544785
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992882609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 101 AVENUE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11416",
            "telephone_number": "718-484-6790",
            "fax_number": "718-848-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 101 AVENUE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "11416",
            "telephone_number": "718-484-6790",
            "fax_number": "718-848-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MOONYANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "115199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00211849",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asma Khatun
• Dmitriy Khelemskiy, L.AC
• Shafiq Rehman Khokhar, MD
• Laurian Kidd
• Kids Development Services Inc
• Woosup Kim, MD
• Kings 26 Dentistry
• Alisa Klimova, PHARM. D
• Knickerbocker Dialysis Inc
• Krasner Chiropractic PC

• Pediatrics Physician in Ozone Park, NY
• Providers in Ozone Park, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.