Individual provider Active NPI

Melissa Kim

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1043852585
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
620 W Lexington St
Baltimore, MD 21201-1508
Phone
(443) 421-9049
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

620 W Lexington St
Baltimore, MD 21201-1508

Mailing address

8512 Country Brooke Way
Lutherville Timonium, MD 21093-4766
Phone (443) 431-9049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220606001532 NY Practitioner - Physician Assistant 2466830369 Reassigns benefits to 1 organization
I20250611003935 DC Practitioner - Physician Assistant 2466830369 Reassigns benefits to 1 organization
I20250628000378 MD Practitioner - Physician Assistant 2466830369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH MD Management LLCGroup PAC ID 2466841028, 70 clinicians

Practice addresses (Care Compare)

11804 Reisterstown Rd
Reisterstown, MD 21136-3311
Phone (410) 870-5094

1211 Liberty Rd
Eldersburg, MD 21784-7927
Phone (410) 617-9129

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CRH MD Management LLC CurrentSince Jun 5, 2025 Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684

11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094

14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800

Interoperability endpoints

  • Direct secure messaging: melissa.kim@ghuc.eclinicaldirectplus.com

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1043852585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8512 COUNTRY BROOKE WAY",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210934766",
            "telephone_number": "443-431-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W LEXINGTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011508",
            "telephone_number": "443-421-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.