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ANDY JI YONG KIM MD
NPI 1457047904
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since April 17, 2023PECOS Enrolled
330 BROOKLINE AVE, BOSTON, MA 02215(617) 667-7000 Get Directions Write a Review

NPPES record last updated: April 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andy Ji Yong Kim Md NPPES

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

ANDY JI YONG KIM MD (NPI 1457047904) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457047904
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameANDY JI YONG KIMCredential: MD
Location Address330 BROOKLINE AVEBoston, MA 02215-5400
Mailing Address330 Brookline AveBoston, MA 02215-5400 · (617) 667-7000
Phone(617) 667-7000
Sole ProprietorNo
Enumeration DateApril 17, 2023
NPPES CertifiedApril 17, 2023
✔ NPI 1457047904 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.
330 BROOKLINE AVE, Boston, MA 02215
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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)

Andy Ji Yong 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.

BETH ISRAEL DEACONESS MEDICAL CENTER
Chronic Disease Hospital (Children)
330 BROOKLINE AVE
BOSTON, MA 02215
Suffolk County (617) 677-4042
DR. BRIAN DANIEL HOBBS MD, MMSC
Internal Medicine
330 BROOKLINE AVE, PULMONARY AND CRITICAL CARE DEPARTMENT
BOSTON, MA 02215
Suffolk County (617) 667-5864
ERICA DOMMASCH MD
Dermatology
330 BROOKLINE AVE, SHAPIRO 2
BOSTON, MA 02215
Suffolk County (617) 667-3753
VAHID KIARAD M.D
Anesthesiology
330 BROOKLINE AVE
BOSTON, MA 02215
Suffolk County (617) 667-7000
DR. JONATHAN DAVID THOMAS MD
Internal Medicine (Hematology)
330 BROOKLINE AVE
BOSTON, MA 02215
Suffolk County (617) 667-7000
JULIA MARIE BERG MD
Internal Medicine
330 BROOKLINE AVE
BOSTON, MA 02215
Suffolk County (617) 667-7000
DR. MICHAEL R GOLDSTEIN PHD
Psychologist (Clinical)
330 BROOKLINE AVE
BOSTON, MA 02215
Suffolk County (617) 356-7246
SARA MURDOCK CAHILL MD
Hospitalist
330 BROOKLINE AVE
BOSTON, MA 02215
Suffolk County (617) 667-7000

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 Andy Kim's NPI number?

The NPI number for Andy Kim is 1457047904. It was assigned to this individual provider in the NPPES registry on April 17, 2023.

Where is Andy Kim located?

Andy Kim practices at 330 Brookline Ave, Boston, MA 02215. The listed phone number is (617) 667-7000.

What is Andy 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 Andy Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Andy Kim was last updated on April 17, 2023. 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.