DR. SUNG YUP KIM (NPI# 1497913149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497913149 |
| Entity Type | Individual |
| Full Name | DR. SUNG YUP KIM |
| Credential | MD |
| Practice Address |
1190 5th Ave Gp1, 1st Floor New York NY 10029 |
| Mailing Address |
1425 Madison Ave Box 1273 New York NY 10029 |
| Practice Telephone | 2122416918 |
| Practice Fax Number | 2129879310 |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2017-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 261334 | NY | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
261334 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
1190 5TH AVE GP1, 1ST FLOOR |
| City | NEW YORK |
| State | NY |
| Zip Code | 10029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417953779 | Ilene Schulman | Nurse Practitioner | 1190 5th Ave, New York, NY 10029-6503 | 2005-06-22 |
| 1922622653 | Ioannis John Demarakos | Student in an Organized Health Care Education/Training Program | 1190 5th Ave, New York, NY 10029-6503 | 2020-05-28 |
| 1083179394 | Sarah Lamothe | Nurse Practitioner | 1190 5th Ave, New York, NY 10029-6574 | 2019-01-31 |
| 1821562505 | Lorenzo Azzalini | Internal Medicine | 1190 5th Ave, Cardiac Catheterization Laboratory, New York, NY 10029 | 2019-01-16 |
| 1609362516 | Chartaroon Rimsukcharoenchai | Student in an Organized Health Care Education/Training Program | 1190 5th Ave, New York, NY 10029-6503 | 2018-07-03 |
| 1104330786 | Martin Thomas Yates | Student in an Organized Health Care Education/Training Program | 1190 5th Ave, New York, NY 10029-6503 | 2017-11-19 |
| 1194246041 | Kyle Green | Physician Assistant | 1190 5th Ave, New York, NY 10029-6503 | 2017-06-30 |
| 1790157535 | Ariel Farkash | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1190 5th Ave, Guggenheim Pavilion-two West, New York, NY 10029-6503 | 2015-10-20 |
| 1528447646 | Ana Claudia Brenner Affonso Da Costa | Student in an Organized Health Care Education/Training Program | 1190 5th Ave, Cardiovascular Department, New York, NY 10029-6503 | 2015-05-21 |
| 1780071829 | Joyce Nader Ghobrial | Physician Assistant | 1190 5th Ave, New York, NY 10029-6503 | 2015-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547029 | Erica Marie Mclaughlin | Counselor | 109 E. 115th Street, New York, NY 10029 | 2020-10-30 |
| 1992305601 | Ayan Kumar | Student in an Organized Health Care Education/Training Program | New York Medical College/ Metropolitan Hospital, 1901, First Avenue, New York City, NY 10029 | 2020-10-30 |
| 1538767306 | Noily Noemi Nezbeth | Registered Nurse | 1 Gustav Levy, New York, NY 10029 | 2020-10-14 |
| 1457959652 | Marwan Nihad Abdel Rauf Yusuf | Student in an Organized Health Care Education/Training Program | Metropolitan Hospital Center Department of Medicine, 1901, 1 St Avenue, New York, NY 10029 | 2020-10-12 |
| 1225635014 | Alice Liang | Registered Nurse | 35 East 110th St, New York, NY 10029 | 2020-10-05 |
| 1013525724 | Avihai Moscovici | Student in an Organized Health Care Education/Training Program | 1 Gustave L. Levy Pl, New York, New York, NY 10029 | 2020-07-20 |
| 1912523473 | Gayathri Sreenivasan | Student in an Organized Health Care Education/Training Program | 1901, 1st Avenue, Metropolitan Hospital Center, Department of Pediatrics, New York, NY 10029 | 2020-06-22 |
| 1417572801 | Rachana Borkar | Student in an Organized Health Care Education/Training Program | 1901, 1st Avenue, New York, Metropolitan Hospital Center Department of Int Medicine, New York, NY 10029 | 2020-06-11 |
| 1831713197 | Dania Isabel Antunez | Student in an Organized Health Care Education/Training Program | 1901 1 St Avenue, New York, NY 10029 | 2020-06-02 |
| 1972122323 | Antoine Beayno | Student in an Organized Health Care Education/Training Program | The Mount Sinai Hospital- 1468 Madison Ave, New York City, NY 10029 | 2020-04-15 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914483 | Star Veins Centers PC | Surgery | 225 W 35th St Frnt 2, New York, NY 10001-1904 | 2018-12-31 |
| 1033631064 | St. Nicholas Professional Medical Services of New York LLC | Surgery | 1264 Saint Nicholas Ave Ste A, New York, NY 10033-7263 | 2017-07-11 |
| 1417340134 | Washington Heights Medical of New York LLC | Surgery | 4159 Broadway, New York, NY 10033-3702 | 2015-03-05 |
| 1154613214 | Bakir Mohammed Altai | Surgery | 606 W 146th St, New York, NY 10031-4305 | 2011-05-09 |
| 1245547124 | Milton Waner Md, Pllc | Surgery | 126 W 60th St, New York, NY 10023-7402 | 2010-09-13 |
| 1114097094 | Windsor Ting, Md | Surgery | 128 Mott St Ste 701, New York, NY 10013-5575 | 2006-11-08 |
| 1538255336 | Robert J Mulcare Md PC | Surgery | 3 East 74th St, Suite 1e, New York, NY 10021-2604 | 2006-10-05 |
| 1619061926 | Moshe N Haimov | Surgery | 12 E 97th St, New York, NY 10029-6918 | 2006-10-03 |
| 1346331519 | Richard W Schutzer | Surgery | 161 Fort Washington Ave Ste 532, New York, NY 10032-3729 | 2006-09-27 |
| 1659470219 | Danielle R Bajakian | Surgery | 161 Ft Washingtn Ave Fl 5, Columbia University- Dept of Surgey, New York, NY 10032-3729 | 2006-09-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.