Bokkyu Kim, PT, PHD
NPI 1720879729ActiveIndividual· Physical Therapist· Fayetteville, NY
Physical Therapist (PT, PHD) in Fayetteville, New York, licensed in NY, with an NPI issued in May 2025. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1720879729 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, PHD |
| Sole proprietor | No |
| NPI issued | May 16, 2025 |
| Last updated in NPPES | Nov 17, 2025 |
| Certified by provider | Nov 17, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 040603 | NY |
| Physical Therapist, Neurology | 2251N0400X | 040603 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NY) |
|---|
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
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