LISA JIYOUNG KIM (NPI# 1548754385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548754385 |
| Entity Type | Individual |
| Full Name | LISA JIYOUNG KIM |
| Credential | FNP-C |
| Practice Address |
830 Harrison Ave Moakley, 3rd Floor Boston MA 02118 |
| Mailing Address |
801 Albany Street Floor Ground Boston MA 02119 |
| Practice Telephone | 6176386428 |
| Practice Fax Number | 6176385756 |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2020-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN2278996 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110146618A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235752569 | Lisa Ann Kim | Occupational Therapist | 13562 Purdy St, Garden Grove, CA 92844-2522 | 2020-05-20 |
| 1700288305 | Lisa Young Kim | Pharmacist | 2100 Valencia Dr Apt 305, Northbrook, IL 60062-7088 | 2014-09-25 |
| 1942341250 | Lisa Sunhee Kim | Internal Medicine | 2604 Dempster St Ste 300, Park Ridge, IL 60068-8427 | 2007-02-09 |
| 1811061674 | Lisa R Kim | Dentist | 241 S Beverly Dr, Beverly Hills, CA 90212-3807 | 2006-11-20 |
| 1982795753 | Lisa M Kim | Internal Medicine | 3355 Rogers Ave, Ellicott City, MD 21043-4105 | 2006-09-27 |
| 1154969160 | Lisa Kim | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2019-12-20 |
| 1093276842 | Lisa Kim | Student in an Organized Health Care Education/Training Program | 395 W 12th Ave Fl 3, Columbus, OH 43210-1267 | 2019-03-26 |
| 1972087773 | Lisa Jisun Kim | Student in an Organized Health Care Education/Training Program | 240 E Huron St Ste 1-200, Chicago, IL 60611-2909 | 2018-09-18 |
| 1427577931 | Lisa Kim | Pharmacist | 13000 Indian School Rd Ne, Albuquerque, NM 87112-4803 | 2017-09-15 |
| 1063818565 | Lisa Kim | Counselor | 3800 Coolidge Ave, Oakland, CA 94602-3311 | 2014-11-10 |
| Street Address |
830 HARRISON AVE MOAKLEY, 3RD FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316937436 | Minh Tam Truong | Radiology | 830 Harrison Ave, Moakley Building Ll100, Boston, MA 02118 | 2005-10-28 |
| 1457950131 | Maggie Ruderman | Genetic Counselor, MS | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-10-22 |
| 1760096606 | Fabio Petrocca | Student in an Organized Health Care Education/Training Program | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-09-08 |
| 1801447495 | Kailey Vitale | Speech-Language Pathologist | 830 Harrison Ave, Boston, MA 02118-2905 | 2019-09-25 |
| 1437718228 | Kayla Mcdonald | Physician Assistant | 830 Harrison Ave, Moakley, Suite 3400, Boston, MA 02118 | 2019-06-06 |
| 1154984888 | Elizabeth Tiani | Nurse Practitioner | 830 Harrison Ave, Boston, MA 02118 | 2019-04-18 |
| 1669938981 | Lynsie Rae Adams | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2019-02-11 |
| 1891226650 | Navid Alavi | Internal Medicine | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2017-03-23 |
| 1952842189 | Samuel Rubin | Otolaryngology | 830 Harrison Ave, 1st Floor, Boston, MA 02118-2905 | 2017-03-20 |
| 1487194833 | Tashia Prince-lacombe | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2017-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968461 | Naira Aleksanyan | Nurse Practitioner | 5 Ellis St, Boston, MA 02119-3728 | 2020-10-04 |
| 1154930048 | Patricia M Ciarleglio | Nurse Practitioner | 51 Franklin St Ste 400, Boston, MA 02110-1335 | 2020-07-27 |
| 1689292161 | Barbara Regina Massa | Nurse Practitioner | 738 E 5th St, Boston, MA 02127-3260 | 2020-07-10 |
| 1114541976 | Ellie Gonyeau | Nurse Practitioner | 17 S Russell St, Boston, MA 02114-3990 | 2020-06-07 |
| 1295357390 | Margaret Sherwood | Nurse Practitioner | 155 W Concord St # 1, Boston, MA 02118-1507 | 2020-05-12 |
| 1760017008 | Venifa White | Nurse Practitioner | 40 Kingsdale St Apt 4, Boston, MA 02124-1700 | 2020-03-06 |
| 1063059467 | Shevonne Renee Linnane | Nurse Practitioner | 619 Adams St Apt 1, Boston, MA 02122-2569 | 2019-12-04 |
| 1730737602 | Melanie Matthews | Nurse Practitioner | 14 Worthington St, Boston, MA 02120-1605 | 2019-09-03 |
| 1114585940 | Jessica Paige Oliver | Nurse Practitioner | 2557 State Line Rd, Boston, GA 31626-2441 | 2019-06-05 |
| 1760944748 | Melissa Stanvick | Nurse Practitioner | 117 Park Dr Apt 5, Boston, MA 02215-5114 | 2019-04-01 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.