Active NPI
Justin Kim
- Anesthesiology Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 263934-1
- Practice address
- 62 Columbia St
Orlando, FL 32806-1115 - Phone
- (407) 514-3668
- Fax
- (321) 843-2196
- NPI assigned
- Oct 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 263934-1 | NY | Primary |
| Anesthesiology Physician | 207L00000X | ME136181 | FL |
Addresses
Primary practice location
62 Columbia St
Orlando, FL 32806-1115
Mailing address
62 Columbia St
Orlando, FL 32806-1115
Phone (407) 514-3668
Other practice location 1
622 West 168th Street
Dept. of Anesthesiology
New York, NY 10032
Phone (212) 305-3226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120895200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Florida State University College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851
Hospital & facility affiliations
- Orlando Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.91 of 100
- Quality
- 61.18
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 263934-1 | NY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Orlando Health Medical Group Inc | Current | Accepting new patients |
Locations
555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200
32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820
62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903
83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1669429577
-
- Durable Medical Equipment & Medical Supplies
- Winter Park, FL
- NPI 1265019541
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1043463276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 COLUMBIA ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061115",
"telephone_number": "407-514-3668",
"fax_number": "321-843-2196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 COLUMBIA ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061115",
"telephone_number": "407-514-3668",
"fax_number": "321-843-2196"
}
],
"practiceLocations": [
{
"address_1": "622 West 168th Street",
"address_2": "Dept. of Anesthesiology",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "10032",
"country_code": "US",
"telephone_number": "212-305-3226",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-31",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "263934-1",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME136181",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120895200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.