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

Mr. Taesoo Kim

Individual provider Medical Physician Assistant · NPI 1538428388

Mr. Taesoo Kim is a Physician Assistant in Brooklyn, New York. Qualified in 2011, 15 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
15
Licensed in
NY
In the registry since
2012
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Practice location Address checks out

1396 Myrtle Ave
Brooklyn, NY 11237-4513
Phone: (718) 878-4314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 015595 (NY)

Record details

NPI number1538428388
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 15, 2012
Last updated in NPPESFebruary 16, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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