Active NPI
Angela Jeewon Kim, DO
- Internal Medicine Physician
- St Petersburg, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OS20164
- Practice address
- 620 10TH St N Ste 1E
St Petersburg, FL 33705-1407 - Phone
- (727) 824-3120
- NPI assigned
- May 12, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS20164 | FL | Primary |
| Internal Medicine Physician | 207R00000X | 5151014483 | MI |
Addresses
Primary practice location
620 10TH St N Ste 1E
St Petersburg, FL 33705-1407
Mailing address
2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-0002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Legacy Healthcare Services Inc
Practice addresses (Care Compare)
17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042
2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060
620 10TH St N
St Petersburg, FL 33705-1407
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS20164 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Medical Group, Inc | Current | Accepting new patients | |
| Baycare Medical Group, Inc. | Current | Accepting new patients | |
| Baycare Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234
2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060
6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300
620 10th St N
Ste 1E
St Petersburg, FL 33705
Phone (727) 824-3120
620 10th St N
Ste 3E
St Petersburg, FL 33705
Phone (727) 824-8209
Interoperability endpoints
- akim597015@direct.hfhs.org
- angela.kimdo@direct.mybaycare.org
Organizations & group practices 3
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.
-
- General Practice Physician
- Clearwater, FL
- NPI 1043269871
Internal Medicine
-
- Family Medicine Physician
- Clearwater, FL
- NPI 1497117329
-
- Family Medicine Physician
- Clearwater, FL
- NPI 1659720837
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Anthonys Hospital
- General Acute Care Hospital
- St Petersburg, FL
- NPI 1427024942
-
dba St. Joseph's Women's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1346519816
-
dba St. Joseph's Hospital
- General Acute Care Hospital
- Tampa, FL
- NPI 1881632818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771891200000",
"number": "1093337107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2995 DREW ST FL 2",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337593012",
"telephone_number": "727-532-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 10TH ST N STE 1E",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337051407",
"telephone_number": "727-824-3120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ANGELA",
"middle_name": "JEEWON",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-12",
"last_updated": "2026-02-24",
"certification_date": "2026-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "OS20164",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5151014483",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.