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JISUN KIM
NPI 1427562495
Physician Assistant - Medical in Bronx, NY

Active since November 28, 2017PECOS Enrolled
111 E 210TH ST, BRONX, NY 10467(718) 920-4321 Get Directions Write a Review

NPPES record last updated: November 28, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jisun Kim NPPES

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

JISUN KIM (NPI 1427562495) is an individual medical provider in Bronx, New York and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427562495
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJISUN KIM
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address3225 Johnson Ave Apt 5aBronx, NY 10463-3517 · (646) 712-0442
Phone(718) 920-4321
Sole ProprietorNo
Enumeration DateNovember 28, 2017
✔ NPI 1427562495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
111 E 210TH ST, Bronx, NY 10467
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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)

Jisun 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.

MS. CALETHA DICKS CRNA
Nurse Anesthetist, Certified Registered
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4316
DR. LEONARD FREEMAN MD
Nuclear Medicine
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-6060
PING ZHOU MD
Pediatrics (Pediatric Endocrinology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4664
DR. RICHARD HERBERT SAVEL MD
Internal Medicine (Critical Care Medicine)
111 E 210TH ST, MONTEFIORE MEDICAL CENTER
BRONX, NY 10467
Bronx County (718) 920-5443
DR. THOMAS B PERERA M.D.
Emergency Medicine
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-6626
DR. FRED SMITH M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
111 E 210TH ST, MONTEFIORE MED CTR DEPT PATHOLOGY
BRONX, NY 10467
Bronx County (718) 920-4976
KAYANN WILSON
Nurse Practitioner (Adult Health)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-7738
HENRY M USHAY MD
Pediatrics
111 E 210TH ST, ROSENTHAL 4
BRONX, NY 10467
Bronx County (718) 741-2463

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 Jisun Kim's NPI number?

The NPI number for Jisun Kim is 1427562495. It was assigned to this individual provider in the NPPES registry on November 28, 2017.

Where is Jisun Kim located?

Jisun Kim practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 920-4321.

What is Jisun Kim's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jisun Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jisun Kim was last updated on November 28, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.