David Hyun Min Kim, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A92002 Issued in CA

Practice address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Phone

(952) 595-1301

Fax

(612) 294-4903

NPI assigned

Jun 5, 2006

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Newport Diagnostic Radiology, Inc

  • Diagnostic Radiology Physician
  • Newport Beach, CA
  • NPI 1134345473
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Advantage MRI Roseville LP

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Roseville, CA
  • NPI 1346775665
  NPD
• Advantage Plus MRI, Inc

  • Radiology Clinic/Center
  • Santa Ana, CA
  • NPI 1497058242
  NPD
• Open Advantage MRI II

  • Magnetic Resonance Imaging Radiologic Technologist
  • Santa Ana, CA
  • NPI 1336164284
  NPD
• Open Advantage MRI III, Inc

  • Magnetic Resonance Imaging Radiologic Technologist
  • Brea, CA
  • NPI 1780609644
  NPD
• Open Advantage MRI VI, Inc

  • Magnetic Resonance Imaging Radiologic Technologist
  • Sacramento, CA
  • NPI 1962427641
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1689606196
  NPD
• Grundy County Memorial Hospital

  • Critical Access Hospital
  • Grundy Center, IA
  • NPI 1427015585
  NPD (past)
• Sarah Bush Lincoln Health Center

  dba Sarah Bush Lincoln Home Care

  • Home Health Agency
  • Charleston, IL
  • NPI 1922190024
  NPD (past)
• University Advance Bioimaging Associates

  • Nuclear Radiology Physician
  • Los Angeles, CA
  • NPI 1306899695
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1063451086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "HYUN MIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-11-29",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A92002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Faraz Khan, M.D.
• Leah D Khan, M.D.
• Mona Khan, PHARM D
• Tasneem N. Khimji, MD
• Tigist T Kiflu
• Kayla Kim, CPHT
• Ernest W Kinchen III, MD
• Brent James King, MD
• Maya Dionne King
• Kyler Kinnamon, PT

• Diagnostic Radiology Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.