Individual provider Active NPI

Soo-Ok Kim, CRNP/CRNA

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1023059003
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R121222 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-8408
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R121222 MD
Certified Registered Nurse Anesthetist 367500000X R121222 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004

Other identifiers 1

IdentifierTypeStateIssuer
401219400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080530000250 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648340844 Reassigns benefits to 5 organizations
I20120731000402 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648340844 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
First Colonies Anesthesia Associates, LLCGroup PAC ID 8426039744, 339 clinicians
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Columbia Outpatient Sedation LLCGroup PAC ID 3476718792, 29 clinicians
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone (301) 754-7000

2118 Greenspring Dr
Timonium, MD 21093-3112
Phone (410) 560-3480

3407 Olandwood CT
Unit 103
Olney, MD 20832-1447
Phone (301) 570-8671

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3800

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

7120 Minstrel Way
Suite 100
Columbia, MD 21045-5274
Phone (410) 290-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

Merit-based Incentive Payment System (MIPS)

Final score
63.85 of 100Reported as group
Quality
57.47
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R121222MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Johns Hopkins University Current Accepting new patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Sep 1, 2024 Accepting new patients
Johns Hopkins University CurrentSince Mar 5, 2008 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Sep 1, 2024 Accepting new patients
Johns Hopkins University Nurse Anesthetist, Certified Registered CurrentSince Mar 5, 2008 Accepting new patients
Columbia Outpatient Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2025 Accepting new patients
Olney Endoscopy Center PastSince Apr 17, 2025 Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

1419 Forest Dr
Ste 105
Annapolis, MD 21403

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

4940 Eastern Ave
Baltimore, MD 21224

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

600 N Wolfe St
Baltimore, MD 21287

5530 Wisconsin Ave
Ste 1620
Chevy Chase, MD 20815
Phone (301) 717-9800

7120 Minstrel Way
Ste 100
Columbia, MD 21045
Phone (571) 210-4828

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

3407 Olandwood Ct
Unit 103
Olney, MD 20832
Phone (301) 570-8671

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

2118 Greenspring Dr
Timonium, MD 21093
Phone (410) 252-5671

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

Interoperability endpoints

  • Direct secure messaging: skim25024@direct.hopkinsmedicine.org

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1023059003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOO-OK",
        "credential": "CRNP/CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R121222",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R121222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401219400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.