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DR. KWANGSU KIM DPM
NPI 1104095744
Podiatrist in Bayside, NY

Active since February 28, 2008PECOS EnrolledAccepts Medicare Assignment
92.25/100
CMS Quality Rating
21909 NORTHERN BLVD, BAYSIDE, NY 11361(718) 229-9200(866) 668-7533 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kwangsu Kim Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KWANGSU KIM DPM (NPI 1104095744) is an individual podiatrist in Bayside, New York, licensed in New York (N006264-01) and active in the NPI registry since February 2008. He is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2005).

NPPES Registry Identity

NPI1104095744
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. KWANGSU KIMCredential: DPM
Location Address21909 NORTHERN BLVDBayside, NY 11361-3525
Mailing Address21909 Northern BlvdBayside, NY 11361-3525 · (718) 229-9200 · Fax (866) 668-7533
Phone(718) 229-9200
Fax(866) 668-7533
Sole ProprietorYes
Medical School CMSTemple University School Of MedicineGraduated 2005
Enumeration DateFebruary 28, 2008
Last NPPES UpdateOctober 29, 2025
NPPES CertifiedOctober 29, 2025
✔ NPI 1104095744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in NY · N006264-01
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
21909 NORTHERN BLVD, Bayside, NY 11361
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kwangsu Kim Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446325757
PECOS Enrollment IDI20080821000343, I20091214000027
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
371 services185 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
213 services99 patients
Simple separation of fingernail or toenail from nail bed, first nail 11730
This procedure involves the gentle removal of the first nail from its bed, often due to injury or infection. It's performed under local anesthesia to minimize discomfort. The nail will gradually regrow over time.
105 services78 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
104 services76 patients
X-ray of ankle, minimum of 3 views 73610
An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.
81 services42 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
50 services49 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11361 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$82.96 typical visit price
range $21.62 – $163.52
Typical copayment $20.74 (range $5.40 – $40.88)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Promoting Interoperability53
Improvement Activities40

Reported Quality Measures

e-Prescribing
100%4,462 patients5/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
41%1,626 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise L1810
DME-Orthotic Devices · category DF011N
2 suppliers11 claims20 services$64.49 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KS PODIATRY PC
Podiatrist (Foot & Ankle Surgery)
21909 NORTHERN BLVD
BAYSIDE, NY 11361
Queens County (718) 229-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kwangsu Kim's NPI number?

The NPI number for Kwangsu Kim is 1104095744. It was assigned to this individual provider in the NPPES registry on February 28, 2008.

Where is Kwangsu Kim located?

Kwangsu Kim practices at 21909 Northern Blvd, Bayside, NY 11361. The listed phone number is (718) 229-9200.

What is Kwangsu Kim's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Kwangsu Kim enrolled in Medicare?

Yes. Kwangsu Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kwangsu Kim was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.