Carolyn Kim, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

239504 Issued in NY

Practice address

2005 West Park Drive, Suite 120
Irving, TX 75061-7506

Phone

(972) 827-1130

Fax

(972) 597-4290

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Dermatology

Education

University of Mississippi School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pure Dermatology CenterGroup PAC ID 8729362397, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.1 of 100Reported as individual

Quality

100

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckim458245@direct.sw.org

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.

• Pure Dermatology Center

  • Dermatology Physician
  • Irving, TX
  • NPI 1851836928
  Medicare reassignment Care Compare group NPD Authorized official
• Orbuch, Brand Dermatology Associates LLP

  • MOHS-Micrographic Surgery Physician
  • Bethpage, NY
  • NPI 1992785117

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1063594299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 W PARK DR STE 120",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612034",
            "telephone_number": "972-827-1130",
            "fax_number": "972-597-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 WEST PARK DRIVE, SUITE 120",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750617506",
            "telephone_number": "972-827-1130",
            "fax_number": "972-597-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CAROLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "239504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Killian, PHARMD
• Maureen Killoran
• Kim Chiropractic and Rehab P.C.
• Kim D Tubbs Pmhnp PA Inc
• Annie Kim, DDS
• Chloe Jeehyong Kim, D.D.S
• Denise Y Kim, PHARMD
• Dong Suk Kim, D.C.
• Dong Wook Kim
• Eung Soo Kim, M.D.

• Dermatology Physician in Irving, TX
• Providers in Irving, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.

Verify at the official NPI Registry.