Andrew Jee Soo Kim, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

078379 Issued in GA

Practice address

2701 N Decatur Rd
Decatur, GA 30033-5918

Phone

(404) 501-1000

NPI assigned

May 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

HospitalistAlso: Family Practice

Education

State University of New York Downstate Medical Center, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Ethne Health, IncGroup PAC ID 5092054940, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.kim.1@18426.direct.athenahealth.com
• Direct secure messaging: akim@yourcarecommunity.org
• FHIR API: https://api.platform.athenahealth.com/18426/brand/1/csg/1/fhir/r4
• Direct secure messaging: akim20121@direct.emory.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Ethne Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Clarkston, GA
  • NPI 1538646054

  Corporate Officer

  CMS ownership

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.

• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Ethne Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Clarkston, GA
  • NPI 1538646054

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820

  Family Medicine

  NPD
• Dekalb Medical Center, Inc.

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  NPD (past)
• Dekalb Medical Psych Unit

  • Psychiatric Hospital Unit
  • Decatur, GA
  • NPI 1821099474
  NPD (past)
• Ethne Health

  • Dental Clinic/Center
  • Clarkston, GA
  • NPI 1073389219
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dekalb Medical Center, Inc.

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  Care Compare affiliation

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1053670133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 HOLLY HEDGE RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832334",
            "telephone_number": "914-714-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "404-501-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "887 N Indian Creek Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "GA",
            "postal_code": "300212247",
            "country_code": "US",
            "telephone_number": "470-799-0044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "middle_name": "JEE SOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "078379",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "51074",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "078379",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "078379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidney Foodie LLC
• Kids & Teens Primary Healthcare
• Kids Speak
• Chelsea Kilgore, AUD
• Kim Austin Associates, LLC
• Emily Christine Kim, OTR/L
• Erin Louise Kim
• Grace Kim, LCSW
• Jenny Christine Kim, M.D.
• John Kim

• Hospitalist Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Hospitalist Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.