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BEOM SOO KIM MD
NPI 1477050995
Student in an Organized Health Care Education/Training Program in Manhasset, NY

Active since April 11, 2018PECOS Enrolled
300 COMMUNITY DR, MANHASSET, NY 11030(516) 562-0100 Get Directions Write a Review

NPPES record last updated: April 11, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Beom Soo Kim Md NPPES

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

BEOM SOO KIM MD (NPI 1477050995) is an individual student in an organized health care education/training program in Manhasset, New York and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477050995
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBEOM SOO KIMCredential: MD
Location Address300 COMMUNITY DRManhasset, NY 11030-3816
Mailing Address60 Crittenden Blvd Apt 717Rochester, NY 14620-4024 · (585) 397-4925
Phone(516) 562-0100
Sole ProprietorNo
Enumeration DateApril 11, 2018
✔ NPI 1477050995 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.
300 COMMUNITY DR, Manhasset, NY 11030
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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)

Beom Soo 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.

SAMIT SHAH M.D.
Internal Medicine (Advanced Heart Failure and Transplant Cardiology)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-1427
DR. SAMANTHA LING PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-8761
DR. DIANA RACHAEL NORDQUIST MD
Anesthesiology
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-8630
DR. STEPHEN JOHN CIPOT IV D.O.
Emergency Medicine
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 684-7598
MR. JOSE LUIS CRUZ PA-C
Physician Assistant
300 COMMUNITY DR, NORTH SHORE UNIVERSITY HOSPITAL
MANHASSET, NY 11030
Nassau County (516) 562-3683
SARAH BETH KORNHABER C.R.N.A.
Nurse Anesthetist, Certified Registered
300 COMMUNITY DR, DEPT OF ANESTHESIA
MANHASSET, NY 11030
Nassau County (516) 562-4887
YUSON CHONG NP
Nurse Practitioner (Acute Care)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-2252
THERESA MARY MOUZAKITIS PA
Physician Assistant
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 662-5100

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 Beom Soo Kim's NPI number?

The NPI number for Beom Soo Kim is 1477050995. It was assigned to this individual provider in the NPPES registry on April 11, 2018.

Where is Beom Soo Kim located?

Beom Soo Kim practices at 300 Community Dr, Manhasset, NY 11030. The listed phone number is (516) 562-0100.

What is Beom Soo 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 Beom Soo Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Beom Soo Kim was last updated on April 11, 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.