DR. BOKKYU KIM PT, PHD
NPI 1720879729
Physical Therapist in Fayetteville, NY

Active since May 16, 2025Accepts Medicare Assignment
4000 MEDICAL CENTER DR, STE 108, FAYETTEVILLE, NY 13066(213) 400-3279 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 17, 2025, Sep 12, 2025, May 22, 2025 and 1 more (4 updates tracked since 2025).

About Dr. Bokkyu Kim Pt, Phd NPPES

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

DR. BOKKYU KIM PT, PHD (NPI 1720879729) is an individual physical therapist in Fayetteville, New York, licensed in New York (040603) and active in the NPI registry since May 2025. He is a graduate of Other (2006).

NPPES Registry Identity

NPI1720879729
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameDR. BOKKYU KIMCredential: PT, PHD
Location Address4000 MEDICAL CENTER DR, STE 108Fayetteville, NY 13066
Mailing Address7282 Dabney LnFayetteville, NY 13066-1823 · (213) 400-3279
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateMay 16, 2025
Last NPPES UpdateNovember 17, 20254 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
NPI 1720879729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in NY · 040603
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
Also ListedPhysical Therapist · NeurologyTaxonomy 2251N0400X · License 040603 (NY)
4000 MEDICAL CENTER DR, Fayetteville, NY 13066

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

Dr. Bokkyu Kim Pt, Phd 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 ID2163919523
PECOS Enrollment IDI20251114000905

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
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Acupuncturist
4000 MEDICAL CENTER DR, SUITE 209
FAYETTEVILLE, NY 13066
Clinic/Center (Physical Therapy)
4000 MEDICAL CENTER DR, STE 108
FAYETTEVILLE, NY 13066
Optometrist
4000 MEDICAL CENTER DR, SUITE 207
FAYETTEVILLE, NY 13066
Neurological Surgery
4000 MEDICAL CENTER DR, SUITE 108
FAYETTEVILLE, NY 13066
Nurse Practitioner (Family)
4000 MEDICAL CENTER DR, UNIT 110
FAYETTEVILLE, NY 13066
Family Medicine
4000 MEDICAL CENTER DR, SUITE 104
FAYETTEVILLE, NY 13066
Pediatrics
4000 MEDICAL CENTER DR, SUITE 214
FAYETTEVILLE, NY 13066
Physician Assistant
4000 MEDICAL CENTER DR, SUITE 101 D
FAYETTEVILLE, NY 13066

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 Bokkyu Kim's NPI number?

The NPI number for Bokkyu Kim is 1720879729. It was assigned to this individual provider in the NPPES registry on May 16, 2025.

Where is Bokkyu Kim located?

Bokkyu Kim practices at 4000 Medical Center Dr Ste 108, Fayetteville, NY 13066. The listed phone number is (213) 400-3279.

What is Bokkyu Kim's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Bokkyu Kim enrolled in Medicare?

Yes. Bokkyu 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.

When was this NPI record last updated?

The NPPES record for Bokkyu Kim was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.