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

Tae Jin Kim

Individual provider Physical Therapist · NPI 1386028801

Tae Jin Kim is a Physical Therapist in Private Practice in Flushing, New York. Qualified in 2011, 15 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
15
Licensed in
NY
In the registry since
2015
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Practice location Address checks out

19904 47th Ave Apt 1
Flushing, NY 11358-3955
Phone: (929) 373-5772
Fax: (914) 462-4372
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 105 Newbridge Rd, Hicksville, NY 11801-3901 — (845) 827-3469

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 030060 (NY)

Record details

NPI number1386028801
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 14, 2015
Last updated in NPPESJanuary 12, 2023
Certification dateJanuary 12, 2023
Mailing address19904 47th Ave Apt 1, Flushing, NY 11358-3955

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Flushing