Individual provider Active NPI

Johnny Jongsun Kim, M.D

  • Personal Emergency Response Attendant
  • Framingham, MA
National Provider Identifier
1023097375
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Emergency Response AttendantTaxonomy code 146D00000X
License
M-1759 Issued in GU
Practice address
117 Lincoln St
Framingham, MA 01702-6358
Phone
(508) 383-1104
NPI assigned
Jan 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X M-1759 GU Primary

Addresses

Primary practice location

117 Lincoln St
Framingham, MA 01702-6358

Mailing address

159 Leon Guerrero Dr
1001 Blue Pacific Lattice Condo
Tamuning, GU 96913-4459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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

Enrollment IDStateProvider typePAC IDDetails
I20140505001822 GU Practitioner - Emergency Medicine 0143396978 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
George Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guam Memorial HospitalGroup PAC ID 5890781694, 132 clinicians

Practice addresses (Care Compare)

850 Gov Carlos Camacho Rd
Tamuning, GU 96913-3128

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3128
Phone (671) 647-2552

Hospital & facility affiliations

  • Guam Memorial Hospital Authority Hospital, Tamuning, GU, CCN 650001

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince Jan 11, 2014 Accepting new patients
Guam Memorial Hospital CurrentSince Jan 11, 2014 Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Aug 31, 2015 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

Organizations & group practices 3

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 1

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": "1137196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1023097375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 LEON GUERRERO DR",
            "address_2": "1001 BLUE PACIFIC LATTICE CONDO",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026358",
            "telephone_number": "508-383-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHNNY",
        "middle_name": "JONGSUN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-14",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "GU",
            "license": "M-1759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.