Soon Ja Kim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0022832 Issued in MD

Practice address

5808 Main St
Elkridge, MD 21075-5105

Phone

(410) 796-7730

Fax

(410) 379-1537

NPI assigned

Dec 23, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Specialty

Family Practice

Education

Woman'S Medical College, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

23.57 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

78.58

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Soon Ja Kim MD PA

  • Adult Medicine Physician
  • Elkridge, MD
  • NPI 1669796710
  Medicare reassignment NPD Authorized official
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1023095643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5808 MAIN ST",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755105",
            "telephone_number": "410-796-7730",
            "fax_number": "410-379-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 MAIN ST",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755105",
            "telephone_number": "410-796-7730",
            "fax_number": "410-379-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOON",
        "middle_name": "JA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0022832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "794391100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Leigh Ketterer, NP
• KG Mental Help
• Nayri Khairalla, PHARMD
• Kamana Khanal, DNP
• Arundati Kharel Sigdel
• Hope King, LMSW
• Tracie M King, O.D.
• Christopher Taylor Klein, MS
• Yaa Asantewaa Kafui Klu, PHD, MPH, RDN, CPH
• Natalie Krenz, LGMFT

• Family Medicine Physician in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.