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JU YEON KIM
NPI 1710764550
Nurse Practitioner - Family in Fayetteville, NY

Active since September 14, 2023PECOS EnrolledAccepts Medicare Assignment
4000 MEDICAL CENTER, SUITE 212, FAYETTEVILLE, NY 13066(315) 744-1570 Get Directions Write a Review

NPPES record last updated: May 16, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ju Yeon Kim NPPES

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

JU YEON KIM (NPI 1710764550) is an individual family provider in Fayetteville, New York, licensed in New York (351939) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, is affiliated with Oneida Health Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1710764550
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJU YEON KIM
Location Address4000 MEDICAL CENTER, SUITE 212Fayetteville, NY 13066
Mailing Address4000 Medical Center Dr, Suite 212Fayetteville, NY 13066 · (315) 744-1570
Phone(315) 744-1570
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateSeptember 14, 2023
Last NPPES UpdateMay 16, 2024
NPPES CertifiedMay 9, 2024
✔ NPI 1710764550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 351939
4000 MEDICAL CENTER, Fayetteville, NY 13066
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Other Names 1

Former Name (1)Ms. Ju Yeon Kim

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ju Yeon Kim is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850740457
PECOS Enrollment IDI20231207003134
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
109 services95 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
96 services79 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
95 services87 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
20 services18 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Oneida Health Hospital

Acute Care Hospitals · Oneida, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number330115
Location321 Genesee StreetOneida, NY 13421 · Madison County
Emergency services Birthing friendly

St Joseph's Hospital Health Center

Acute Care Hospitals · Syracuse, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330140
Location301 Prospect AvenueSyracuse, NY 13203 · Onondaga County
Emergency services Birthing friendly

Oswego Hospital

Acute Care Hospitals · Oswego, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330218
Location110 West Sixth StreetOswego, NY 13126 · Oswego County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Ju Kim's NPI number?

The NPI number for Ju Kim is 1710764550. It was assigned to this individual provider in the NPPES registry on September 14, 2023. The provider is also known as Ms. Ju Yeon Kim.

Where is Ju Kim located?

Ju Kim practices at 4000 Medical Center Suite 212, Fayetteville, NY 13066. The listed phone number is (315) 744-1570.

What is Ju Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ju Kim enrolled in Medicare?

Yes. Ju Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Ju Kim affiliated with any hospitals?

According to CMS data, Ju Kim is affiliated with Oneida Health Hospital, St Joseph's Hospital Health Center and Oswego Hospital.

When was this NPI record last updated?

The NPPES record for Ju Kim was last updated on May 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.