WOO SUP KIM M D P C
NPI 1104198878
Clinic/Center - Primary Care in Ozone Park, NY
About Woo Sup Kim M D P C NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WOO SUP KIM M D P C (NPI 1104198878) is a healthcare organization registered as a primary care in Ozone Park, New York and active in the NPI registry since January 2012. The organization lists Woo Sup Kim, D.r, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Woo Sup Kim M D P C is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Woo Sup Kim M D P C, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Woo Sup Kim M D P C's NPI number?
The NPI number for Woo Sup Kim M D P C is 1104198878. It was assigned to this organization in the NPPES registry on January 27, 2012.
Where is Woo Sup Kim M D P C located?
Woo Sup Kim M D P C is located at 9711 101st Ave, Ozone Park, NY 11416. The listed phone number is (718) 845-6000.
What is Woo Sup Kim M D P C's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Woo Sup Kim M D P C enrolled in Medicare?
Yes. Woo Sup Kim M D P C is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Woo Sup Kim M D P C?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Woo Sup Kim M D P C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Woo Sup Kim M D P C was last updated on March 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.
# Woo Sup Kim M D P C · NPI 1104198878
Primary Care organization in Ozone Park, New York. Organization record, active in the CMS NPPES registry since January 27, 2012.
## Identity
- **NPI:** 1104198878 (Entity type: Organization)
- **Enumerated:** January 27, 2012
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Woo Sup Kim, D.R
## Practice location
- **Address:** 9711 101ST AVE, Ozone Park, NY 11416-2523
- **Phone:** (718) 845-6000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 2, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1104198878) · Data from the CMS NPPES public registry.