NPIMap

Individual provider Active NPI

James Kim, M.D.

  • Internal Medicine Physician
  • Fort Drum, NY
National Provider Identifier
1073995486
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30018 Issued in NE
Practice address
USA Meddac
11050 Mt. Belvedere Blvd
Fort Drum, NY 13602-5438
Phone
(315) 772-2964
NPI assigned
Jun 22, 2015
Last updated
Dec 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30018 NE Primary

Addresses

Primary practice location

USA Meddac
11050 Mt. Belvedere Blvd
Fort Drum, NY 13602-5438

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center
Tripler Army Medical Center, HI 96859-5001

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL james.j.kim32.mil@mail.mil

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, ME3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221026000613 MA Practitioner - Hospitalist 3779959192 Reassigns benefits to 3 organizations
I20240130002873 NH Practitioner - Internal Medicine 3779959192
I20240201001954 ME Practitioner - Hospitalist 3779959192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Loma Linda University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians

Practice addresses (Care Compare)

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-3511

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.17 of 100Reported as group
Quality
84.29
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30018NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athol Memorial Hospital Incorporated CurrentSince Jul 1, 2022 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2022 Accepting new patients
Valley Regional Hospital Inc. Internal Medicine Current Accepting new patients
York Hospital CurrentSince Dec 20, 2023 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Jul 1, 2022 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

243 Elm St
Claremont, NH 03743
Phone (603) 542-7771

Interoperability endpoints

  • Direct secure messaging: vrhjkim@yourcarecommunity.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1073995486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MT. BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "30018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "james.j.kim32.mil@mail.mil",
            "affiliation": "N",
            "address_1": "11050 Mount Belvedere Blvd",
            "city": "Fort Drum",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136025438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.