Ethan Yooseok Kim, OD in Bayside, NY - Medicare Optometrist Provider

Ethan Yooseok Kim, OD is a medicare enrolled "Optometrist" provider in Bayside, New York. His current practice location is 3925 Bell Blvd, Bayside, New York. You can reach out to his office (for appointments etc.) via phone at (718) 279-2020.

Ethan Yooseok Kim is licensed to practice in New York (license number RT009892) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124805684.

Contact Information

	Ethan Yooseok Kim, OD
	3925 Bell Blvd, Bayside, NY 11361-2060
	(718) 279-2020
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ethan Yooseok Kim
Gender	Male
Speciality	Optometrist
Location	3925 Bell Blvd, Bayside, 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: 1124805684
Provider Enumeration Date: 09/08/2023
Last Update Date: 09/08/2023

Medicare PECOS Information:

PECOS PAC ID: 6507375128
Enrollment ID: I20250604001456

Medical Identifiers

Medical identifiers for Ethan Yooseok Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124805684	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	RT009892 (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. Ethan Yooseok Kim allows following entities to bill medicare on his behalf.

Provider Name	Eye & I Eyecare Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1992369623 PECOS PAC ID: 0749523108 Enrollment ID: O20190528002266

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. Ethan Yooseok 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
Ethan Yooseok Kim, OD 4528 220th Pl, Bayside, NY 11361-3647 Ph: (929) 369-7211	Ethan Yooseok Kim, OD 3925 Bell Blvd, Bayside, NY 11361-2060 Ph: (718) 279-2020

Reviews and Comments

Optometrist in Bayside, NY

Dr. Nadine Amy Cohen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2634 Bell Blvd, Bayside, NY 11360 Phone: 718-428-2020
Arthur Chen, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 20836 Cross Island Pkwy, Bayside, NY 11360 Phone: 718-224-1833 Fax: 718-224-1877
Ch Optometry Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3925 Bell Blvd, Bayside, NY 11361 Phone: 718-279-2020
Dr. Kerinna Molly Mcdonald, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 4101 Bell Blvd, Bayside, NY 11361 Phone: 718-428-6700
Eyes On Bell Inc Optometrist Medicare: Medicare Enrolled Practice Location: 3912 Bell Blvd, Bayside, NY 11361 Phone: 718-221-2020 Fax: 718-281-2355
Kevin Jon Leung, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 3925 Bell Blvd, Bayside, NY 11361 Phone: 718-279-2020

Ethan Yooseok Kim, OD - Medicare Optometrist in Bayside, NY