Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124805684 Individual Practitioner Male Practitioner

Dr. Ethan Yooseok Kim , OD

Optometrist • Bayside, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Kim, OD is a certified Optometrist practicing in Bayside, NY. With approximately 3 years of clinical experience since completing medical education in 2023, Dr. Kim delivers high-quality medical care to the local community at 3925 BELL BLVD.

Dr. Kim is affiliated with Eye And I Eyecare Llc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

3925 Bell Blvd

Bayside, NY 113612060

Telephone 7182792020
Associated Practice Facility / Clinic
🏢 M&k Optical Inc. Facility NPI 1588794093

Medicare Profile & Education

Medical School

Other

Graduation Year

2023

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Bayside, NY

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs -9.7 yrs vs City Avg
City Avg: 12.7 Yrs
State Avg: 23.8 Yrs
Regional Practice Density
11 Specialists

Practicing in Bayside, NY (3674 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kim (3 Years) 3 Yrs
Bayside Specialty Average (12.7 Years) 12.7 Yrs

Medical Specialties & State Licenses

CMS Verified: 2023-09-07
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License NY RT009892

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Hospital & Practice Group Affiliations

Eye And I Eyecare Llc

3925 Bell Blvd, Bayside, NY 113612060

Phone: 7182792020

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1356014377

Doctor of Optometry

Joseph Han

Optometrist

NPI 1649834474
NPI 1760897235

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 08, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location September 08, 2023

Registered at 3925 BELL BLVD, BAYSIDE, NY 113612060 (Tel: 7182792020)

📍
Updated Business Mailing Address September 08, 2023

Registered at 4528 220TH PL, BAYSIDE, NY 113613647 (Tel: 9293697211)

👤
Provider Name / Credentials Updated September 08, 2023

Recorded as ETHAN KIM, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2023

Optometrist (License #RT009892 in NY)

🟢
Initial NPI Registration & Enumeration September 08, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124805684
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 08, 2023
Last Update: September 08, 2023
Sole Proprietor: Yes

Mailing Address

4528 220th Pl

Bayside, NY 113613647

Phone: 9293697211

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.