Jiwon Kim
Nurse Practitioner, Family in New York, NY. Individual provider (NPI-1).
NPI number1033765748
StatusActive
Last updated in NPPESAug 18, 2019
Details
- NPI
- 1033765748
- Entity type
- Individual (NPI-1)
- Name
- Jiwon Kim
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 18, 2019
- Last updated
- Aug 18, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F340545 | NY | Yes |
Practice location
1901 1st AveNew York, NY 10029-7494
Phone 212-423-6262
Mailing address
1106 Glenmore Ave Fl 1Brooklyn, NY 11208-3228
Phone 909-647-7388
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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