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KENNETH KIM
NPI 1164914339
Student in an Organized Health Care Education/Training Program in Jamaica, NY

Active since June 04, 2018PECOS Enrolled
9027 SUTPHIN BLVD, JAMAICA, NY 11435(718) 526-8400 Get Directions Write a Review

NPPES record last updated: June 4, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenneth Kim NPPES

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

KENNETH KIM (NPI 1164914339) is an individual student in an organized health care education/training program in Jamaica, New York and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164914339
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKENNETH KIM
Location Address9027 SUTPHIN BLVDJamaica, NY 11435-3647
Mailing Address9027 Sutphin BlvdJamaica, NY 11435-3647
Phone(718) 526-8400
Sole ProprietorYes
Enumeration DateJune 4, 2018
✔ NPI 1164914339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
9027 SUTPHIN BLVD, Jamaica, NY 11435
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

ANDREW DAVID STEIN LCSW
Social Worker (Clinical)
9027 SUTPHIN BLVD, 5TH FLOOR
JAMAICA, NY 11435
Queens County (718) 526-8400
MR. TYSEN LEON WHITE LCSW
Social Worker (Clinical)
9027 SUTPHIN BLVD
JAMAICA, NY 11435
Queens County (718) 301-5175
ROXANNE DOMENECH LCSW
Social Worker (Clinical)
9027 SUTPHIN BLVD
JAMAICA, NY 11435
Queens County (718) 799-6441
CHANDANI PERSAUD
Student in an Organized Health Care Education/Training Program
9027 SUTPHIN BLVD, 5TH FL
JAMAICA, NY 11435
Queens County (718) 526-8400
ANITA SCHAAL-DWYER RN
Registered Nurse
9027 SUTPHIN BLVD, 5TH FLOOR
JAMAICA, NY 11435
Queens County (718) 526-8400
MS. CAROL BROOKS LCSW
Social Worker (Clinical)
9027 SUTPHIN BLVD, 5TH FLOOR
JAMAICA, NY 11435
Queens County (718) 526-8400
MRS. MARIANNE TRAVERSON RN
Registered Nurse
9027 SUTPHIN BLVD
JAMAICA, NY 11435
Queens County (718) 557-2504
EMMANUELLE PIERRE
Student in an Organized Health Care Education/Training Program
9027 SUTPHIN BLVD
JAMAICA, NY 11435
Queens County (718) 526-8400

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 Kenneth Kim's NPI number?

The NPI number for Kenneth Kim is 1164914339. It was assigned to this individual provider in the NPPES registry on June 4, 2018.

Where is Kenneth Kim located?

Kenneth Kim practices at 9027 Sutphin Blvd, Jamaica, NY 11435. The listed phone number is (718) 526-8400.

What is Kenneth Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kenneth Kim enrolled in Medicare?

Yes. Kenneth Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Kim was last updated on June 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.