SOO JEONG KIM MD
NPI 1306264320
Urology - Pediatric Urology in New York, NY

Q: What is Soo Jeong Kim's NPI number?

The NPI number for Soo Jeong Kim is 1306264320. It was assigned to this individual provider in the NPPES registry on April 7, 2014.

Q: What is Soo Jeong Kim's specialty?

The primary specialty registered for this NPI is Urology, specializing in Pediatric Urology, with taxonomy code 2088P0231X.

Q: When was this NPI record last updated?

The NPPES record for Soo Jeong Kim was last updated on October 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since April 07, 2014PECOS Enrolled

3959 BROADWAY, NEW YORK, NY 10032(212) 305-9918 Get Directions Write a Review

NPPES record last updated: October 26, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Soo Jeong Kim Md NPPES

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

SOO JEONG KIM MD (NPI 1306264320) is an individual pediatric urology provider in New York, New York, licensed in New York (315881) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306264320

Entity TypeIndividualFemale

Primary Taxonomy2088P0231X

Provider Legal NameSOO JEONG KIMCredential: MD

Location Address3959 BROADWAYNew York, NY 10032-1559

Mailing Address161 Fort Washington Ave Fl 11New York, NY 10032-3729 · (212) 305-0114

Phone(212) 305-9918

Sole ProprietorNo

Enumeration DateApril 7, 2014

Last NPPES UpdateOctober 26, 2022

NPPES CertifiedOctober 26, 2022

✔ NPI 1306264320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrology · Pediatric UrologyAllopathic & Osteopathic Physicians

Taxonomy Code2088P0231X

License✔ Licensed in NY · 315881

Definition

Surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele).

3959 BROADWAY, New York, NY 10032

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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 (PECOS)

Soo Jeong Kim Md 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.

DR. PAMELA ISABEL GOOD M.D.

Pediatrics

3959 BROADWAY
NEW YORK, NY 10032

New York County (212) 305-8504

HAE LIN SON

Nurse Practitioner (Neonatal)

3959 BROADWAY
NEW YORK, NY 10032

New York County (201) 696-5960

ELIZABETH ANN BADER

Physician Assistant

3959 BROADWAY
NEW YORK, NY 10032

New York County (212) 305-5437

HYO JIN CHO MD

Student in an Organized Health Care Education/Training Program

3959 BROADWAY
NEW YORK, NY 10032

New York County (212) 305-8504

DR. DAVID RUBENSTEIN

Pediatrics (Neonatal-Perinatal Medicine)

3959 BROADWAY, COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS
NEW YORK, NY 10032

New York County (212) 304-7250

MS. MEREDITH GAROD-MUSIC CPNP

Nurse Practitioner (Pediatrics)

3959 BROADWAY
NEW YORK, NY 10032

New York County (212) 342-8530

EVIANNA CRUZ HERRERA MD/MPH

Pediatrics (Pediatric Gastroenterology)

3959 BROADWAY
NEW YORK, NY 10032

New York County (212) 305-5903

SARA BOMBONATO OTR/L

Occupational Therapist

3959 BROADWAY
NEW YORK, NY 10032

New York County (212) 305-5827

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 Soo Jeong Kim's NPI number?

The NPI number for Soo Jeong Kim is 1306264320. It was assigned to this individual provider in the NPPES registry on April 7, 2014.

Where is Soo Jeong Kim located?

Soo Jeong Kim practices at 3959 Broadway, New York, NY 10032. The listed phone number is (212) 305-9918.

What is Soo Jeong Kim's specialty?

The primary specialty registered for this NPI is Urology, specializing in Pediatric Urology, with taxonomy code 2088P0231X.

Is Soo Jeong Kim enrolled in Medicare?

Yes. Soo Jeong Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Soo Jeong Kim was last updated on October 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.