Matthew J. Kim, MK

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K7444 Issued in TX

Practice address

11041 Shadow Creek Pkwy
Suite# 123
Pearland, TX 77584-7402

Phone

(713) 436-5550

Fax

(713) 436-7177

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Thrity Desai MD PA

  • Pediatrics Physician
  • Houston, TX
  • NPI 1104022060
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1023087608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11041 SHADOW CREEK PKWY",
            "address_2": "SUITE# 123",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847402",
            "telephone_number": "713-436-5550",
            "fax_number": "713-436-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11041 SHADOW CREEK PKWY",
            "address_2": "SUITE# 123",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847402",
            "telephone_number": "713-436-5550",
            "fax_number": "713-436-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K7444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092460702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092460701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Kibaara, M.S., CCC-SLP
• Kidneyspa in-Home Dialysis SE Texas LLC
• Christine Kilgallen, LPC
• Andrew J Kim, DO
• Chun M Kim, PHARMD
• Steven Kim, PA-C
• Lori Kimble
• Kinetic Speech Services, PLLC
• Carrie Lynn King
• Katrina Marie King

• Pediatrics Physician in Pearland, TX
• Providers in Pearland, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.