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MS. JIYOON KIM PA-C
NPI 1912046665
Physician Assistant - Surgical in New York, NY

Active since February 06, 2007PECOS Enrolled
425 E 61ST ST FL 10, WEILL CORNELL BREAST CENTER, NEW YORK, NY 10065(646) 772-8109 Get Directions Write a Review

NPPES record last updated: July 14, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 14, 2016, Jan 22, 2016 (2 updates tracked since 2016).

About Ms. Jiyoon Kim Pa-c NPPES

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

MS. JIYOON KIM PA-C (NPI 1912046665) is an individual surgical provider in New York, New York, licensed in New York (010657-1) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912046665
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMS. JIYOON KIMCredential: PA-C
Location Address425 E 61ST ST FL 10, WEILL CORNELL BREAST CENTERNew York, NY 10065-8722
Mailing Address24117a Oak Park DrDouglaston, NY 11362-2611 · (646) 772-8109
Phone(646) 772-8109
Sole ProprietorNo
Enumeration DateFebruary 6, 2007
Last NPPES UpdateJuly 14, 20162 updates tracked since enumeration
✔ NPI 1912046665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NY · 010657-1
425 E 61ST ST FL 10, New York, NY 10065
Open in Google Maps ↗

Other Names 1

Former Name (1)Ms. Ji Yoon Song

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Jiyoon Kim Pa-c 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 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE MARIE VOLPE NP
Nurse Practitioner
425 E 61ST ST FL 10
NEW YORK, NY 10065
New York County (646) 962-2888
DR. LISA GFRERER M.D. PH. D.
Plastic Surgery
425 E 61ST ST FL 10
NEW YORK, NY 10065
New York County (646) 962-4250
ADAM JACOBY MD
Plastic Surgery
425 E 61ST ST FL 10
NEW YORK, NY 10065
New York County (646) 962-4250

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 Jiyoon Kim's NPI number?

The NPI number for Jiyoon Kim is 1912046665. It was assigned to this individual provider in the NPPES registry on February 6, 2007. The provider is also known as Ms. Ji Yoon Song.

Where is Jiyoon Kim located?

Jiyoon Kim practices at 425 E 61st St Fl 10 Weill Cornell Breast Center, New York, NY 10065. The listed phone number is (646) 772-8109.

What is Jiyoon Kim's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jiyoon Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jiyoon Kim was last updated on July 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.