Individual provider Active NPI

Yeonsoo James Kim, M.D.

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1043575186
Registry record updated May 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
17020 Issued in NV
Practice address
2950 S Maryland Pkwy
Las Vegas, NV 89109-2204
Phone
(702) 240-1215
Fax
(702) 243-7531
NPI assigned
Jul 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 17020 NV Primary

Addresses

Primary practice location

2950 S Maryland Pkwy
Las Vegas, NV 89109-2204

Mailing address

PO Box 36900
Las Vegas, NV 89133-6900
Phone (702) 240-1215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20170711000560 NV Practitioner - Diagnostic Radiology 5799077335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sdmi, LLCGroup PAC ID 7911897053, 36 clinicians

Practice addresses (Care Compare)

2767 N Tenaya Way
Las Vegas, NV 89128-0425
Phone (702) 732-6000

Merit-based Incentive Payment System (MIPS)

Final score
84.74 of 100Reported as group
Quality
82.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17020NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sdmi, LLC Diagnostic Radiology CurrentSince Jul 3, 2017 Accepting new patients
Hoffman, MD, Associated Pathologists Chartered PastSince Jul 3, 2017 Accepting new patients

Locations

4 Sunset Way
Ste D
Henderson, NV 89014

4 Sunset Way
Henderson, NV 89014
Phone (215) 680-3255

2850 Siena Heights Dr
Henderson, NV 89052

800 N Gibson Rd
Ste 110
Henderson, NV 89011

6925 N Durango Dr
Las Vegas, NV 89149

9070 W Post Rd
Las Vegas, NV 89148

8945 Lindell Rd
Las Vegas, NV 89139

10040 Alta Dr
Ste 170
Las Vegas, NV 89145
Phone (701) 732-6000

2767 N Tenaya Way
Las Vegas, NV 89128

2950 S Maryland Pkwy
Las Vegas, NV 89109

800 Shadow Ln
Las Vegas, NV 89106
Phone (702) 366-9700

31 N Nellis Blvd
Las Vegas, NV 89110

1650 W Craig Rd
Ste 100
North Las Vegas, NV 89032

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.

NPI Registry JSON

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

{
    "created_epoch": "1341360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494028800000",
    "number": "1043575186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36900",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891336900",
            "telephone_number": "702-240-1215",
            "fax_number": "702-243-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092204",
            "telephone_number": "702-240-1215",
            "fax_number": "702-243-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEONSOO",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-04",
        "last_updated": "2017-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "17020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.