Look up the most recent NPI and PECOS records

Jin Yi Kim

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2015 Grand Concourse, Bronx, NY 10453

PECOS Enrollment

Based on the most recent information from CMS, provider Jin Yi Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1659801132
Provider Type
Individual
Full Name
Kim, Jin Yi
Gender
Female

Sole Proprietor
Yes
Enumeration Date
6/15/2017
Last Updated
7/21/2022

Contact Information

Practice Location

2015 Grand Concourse, Bronx, NY 10453

(718) 299-7295

Unlisted Fax

Mailing Location

3198 Grand Concourse, Bronx, NY 10458-1000

(718) 618-0401

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License F341150 New York
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP95006383 California

Jin Yi Kim

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Taveras, Gabriela

Ajaero, Vivian

Nilges, Isaac

Boutos, Ekaterini

Kim, Youngsook

Zhang, Xiao

Riobe, Alexandra

Sanchez, Franchesca Teresa

Rengel, Darrel

Nwogu, Mercy Chima