Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kwangsu Kim, DPM

Individual provider Podiatrist · NPI 1104095744

Dr. Kwangsu Kim, DPM is a Podiatry in Bayside, New York. Graduated from Temple University School of Medicine in 2005, 21 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
21
Trained at
Temple University School of Medicine
Licensed in
NY
In the registry since
2008
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

See every abbreviation used in this directory →

Practice location Address checks out

21909 Northern Blvd
Bayside, NY 11361-3525
Phone: (718) 229-9200
Fax: (866) 668-7533
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence N006264-01 (NY)

Record details

NPI number1104095744
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedFebruary 28, 2008
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025
Mailing address21909 Northern Blvd, Bayside, NY 11361-3525

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolTEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Bayside