Minerva Kim, RD is a medicare enrolled "Dietitian, Registered" provider in Greenvale, New York. Her current practice location is
101 Northern Blvd, Greenvale, New York. You can reach out to her office (for appointments etc.) via phone at
(516) 563-7940.
Minerva Kim is licensed to practice in New York (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1740941467.
Healthcare Provider's Profile
| Full Name | Minerva Kim |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 101 Northern Blvd, Greenvale, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1740941467
- Provider Enumeration Date: 01/05/2022
- Last Update Date: 09/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 1850785379
- Enrollment ID: I20220228000712
Medical Identifiers
Medical identifiers for Minerva Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740941467 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Minerva Kim allows following entities to bill medicare on her behalf.
| Provider Name | Chs Physician Partners Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1164585725
PECOS PAC ID: 7618955667
Enrollment ID: O20040708000027 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Minerva Kim is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Minerva Kim, RD
101 Northern Blvd,
Greenvale, NY 11548-1340
Ph: () - | Minerva Kim, RD
101 Northern Blvd,
Greenvale, NY 11548-1340
Ph: (516) 563-7940 |
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