Dae Y Kim, M.D., PH.D

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

31577 Issued in OK

Practice address

1145 S Utica Ave
Suite 202
Tulsa, OK 74104-4000

Phone

(918) 579-3130

Fax

(918) 579-3139

NPI assigned

Aug 28, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

UrologyAlso: General Surgery

Education

State University of New York at Buffalo School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001
• Hillcrest Hospital South Hospital, Tulsa, OK, CCN 370202
• Muscogee (Creek) Nation Medical Center Hospital, Okmulgee, OK, CCN 370057
• Hillcrest Hospital Henryetta Hospital, Henryetta, OK, CCN 370183
• Bailey Medical Center, LLC Hospital, Owasso, OK, CCN 370228

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Networks

• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Interoperability endpoints

• Direct secure messaging: dkim17659@muscogeecreeknation.direct-ci.com
• FHIR API: https://epicproxy.et1221.epichosted.com/FHIRProxy/MCNDH/api/FHIR/R4
• Direct secure messaging: dkim106861@ahs.direct-ci.com
• FHIR API: https://epicproxy.ardenthealth.com/fhir/BMC/api/FHIR/R4/
• FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ahs Oklahoma Physician Group LLC

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1235182775

  Urology

  Medicare reassignment Care Compare group NPD
• Creek Nation Hospital & Clinics

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment Care Compare group NPD
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923
  Medicare reassignment NPD
• Ahs Oklahoma Physician Group, LLC

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051
  NPD
• Creek Nation Hospital & Clinics

  • General Acute Care Hospital
  • Okmulgee, OK
  • NPI 1033511480
  NPD
• Creek Nation Hospital & Clinics

  • Clinic/Center
  • Muskogee, OK
  • NPI 1922873611
  NPD
• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  NPD (past)
• Ahs Southcrest Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Henryetta Hospital LLC

  • General Acute Care Hospital
  • Henryetta, OK
  • NPI 1720053556
  Care Compare affiliation
• Ahs Hillcrest Medical Center, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229
  Care Compare affiliation
• Ahs Southcrest Hospital, LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1750661534
  Care Compare affiliation
• Bailey Medical Center, LLC

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1205846037
  Care Compare affiliation
• Creek Nation Hospital & Clinics

  • Long Term Care Hospital
  • Okmulgee, OK
  • NPI 1376979955
  Care Compare affiliation
• Creek Nation Hospital & Clinics

  • General Acute Care Hospital
  • Okmulgee, OK
  • NPI 1902236573
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1003000597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-579-3130",
            "fax_number": "918-579-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "SUITE 202",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-579-3130",
            "fax_number": "918-579-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "31577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324649801 (MDACC)",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EB319 (MDACC)",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ann Kilpatrick, PHD
• David Kilpatrick
• Mary Kilpatrick, LPC
• Kim James, LPC
• Benjamin Soo Kim
• David Yoonsung Kim
• Hee Won Kim, M.D.
• Hyein Kim, M.D.
• Insung Kim, MD
• Minhye Kim, PHARMD

• Urology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Urology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.