MICHAEL MINJUN KIM D.O.
NPI 1891172722
Family Medicine in Riverhead, NY
About Michael Minjun Kim D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL MINJUN KIM D.O. (NPI 1891172722) is an individual family medicine provider in Riverhead, New York, licensed in New York (292970) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS and is a graduate of Philadelphia College Of Osteopathic Medicine (2015).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Michael Minjun Kim D.o. 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.
Medicare Billing Reassignments
5Medicare enrollment records show Michael Kim reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Riverhead, NY 11901
- Reassigned Medicare billing, New York enrollment
- 134 clinicians in this Medicare group
Mattituck, NY 11952
- Reassigned Medicare billing, New York enrollment
- 70 clinicians in this Medicare group
Huntington, NY 11743
- Reassigned Medicare billing, New York enrollment
- 116 clinicians in this Medicare group
Rockville Centre, NY 11570
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: North Shore Lij Urgent Care PC
- 210 clinicians in this Medicare group
Great Neck, NY 11021
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
RIVERHEAD, NY 11901
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 Michael Kim's NPI number?
The NPI number for Michael Kim is 1891172722. It was assigned to this individual provider in the NPPES registry on April 29, 2015. The provider is also known as Min Joon Kim D.O..
Where is Michael Kim located?
Michael Kim practices at 1300 Roanoke Ave, Riverhead, NY 11901. The listed phone number is (631) 548-6000.
What is Michael Kim's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Michael Kim enrolled in Medicare?
Yes. Michael 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.
Which organizations bill Medicare for Michael Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Michael Kim reassigns Medicare benefits to 5 organizations: Central Suffolk Hospital (Riverhead, NY), Peconic Bay Primary Medical Care (Mattituck, NY), Huntington Hospital Association (Huntington, NY), North Shore Lij, Urgent Care, P.C. (Rockville Centre, NY) and North Shore-Lij Medical PC (Great Neck, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Michael Kim was last updated on June 19, 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.
# Michael Minjun Kim, D.O. · NPI 1891172722
Family Medicine physician in Riverhead, New York. Individual provider, active in the CMS NPPES registry since April 29, 2015.
## Identity
- **NPI:** 1891172722 (Entity type: Individual)
- **Enumerated:** April 29, 2015
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 292970 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1300 ROANOKE AVE, Riverhead, NY 11901
- **Phone:** (631) 548-6000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Central Suffolk Hospital (NPI 1043402050, Riverhead, NY); Peconic Bay Primary Medical Care (NPI 1487620613, Mattituck, NY); Huntington Hospital Association (NPI 1386619385, Huntington, NY); North Shore Lij, Urgent Care, P.C. (NPI 1679970891, Rockville Centre, NY); North Shore-Lij Medical PC (NPI 1053688572, Great Neck, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Philadelphia College Of Osteopathic Medicine, class of 2015
## Record status
- **NPPES last updated:** June 19, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1891172722) · Data from the CMS NPPES public registry.