Ju Yeon Kim, in Fayetteville, NY - Medicare Nurse Practitioner

Ju Yeon Kim, is a medicare enrolled "Nurse Practitioner - Family" in Fayetteville, New York. Her current practice location is 4000 Medical Center, Suite 212, Fayetteville, New York. You can reach out to her office (for appointments etc.) via phone at (315) 744-1570.

Ju Yeon Kim is licensed to practice in New York (license number 351939) 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 1710764550.

Contact Information

	Ju Yeon Kim,
	4000 Medical Center, Suite 212, Fayetteville, NY 13066
	(315) 744-1570
	Not Available

Map and Direction

Provider's Profile

Full Name	Ju Yeon Kim
Gender	Female
Speciality	Nurse Practitioner - Family
Location	4000 Medical Center, Fayetteville, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1710764550
Provider Enumeration Date: 09/14/2023
Last Update Date: 05/16/2024

Medicare PECOS Information:

PECOS PAC ID: 1850740457
Enrollment ID: I20231207003134

Medical Identifiers

Medical identifiers for Ju Yeon Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1710764550	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	351939 (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. Ju Yeon Kim allows following entities to bill medicare on her behalf.

Entity Name	St Josephs Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942501747 PECOS PAC ID: 4688855844 Enrollment ID: O20110221000744

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. Ju Yeon 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
Ju Yeon Kim, 4000 Medical Center Dr, Suite 212, Fayetteville, NY 13066 Ph: (315) 744-1570	Ju Yeon Kim, 4000 Medical Center, Suite 212, Fayetteville, NY 13066 Ph: (315) 744-1570

Reviews and Comments

Nurse Practitioner Nurses in Fayetteville, NY

Mary Oot, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 510 Towne Dr, Fayetteville, NY 13066 Phone: 315-663-0500
Ms. Hannah Joan Walsh, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4101 Medical Center Dr, Fayetteville, NY 13066 Phone: 315-637-7878
Theresa Baxter, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 221 Hunt Dr, Fayetteville, NY 13066 Phone: 315-637-8148
Jayme K Schreck, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 510 Towne Dr, Fayetteville, NY 13066 Phone: 315-663-0500 Fax: 315-663-0514
Taylor Fisher, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6870 E Genesee St, Fayetteville, NY 13066 Phone: 315-679-4367
Mrs. Jenaye Karin Broe, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4000 Medical Center Dr Ste 110, Fayetteville, NY 13066 Phone: 315-663-0100
Kathleen Judith Hergert, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 510 Towne Dr, Fayetteville, NY 13066 Phone: 315-627-0448

Ju Yeon Kim, - Medicare Nurse Practitioner in Fayetteville, NY