NPIMap

Individual provider Active NPI

Joon Yim, M.D.

  • Anatomic Pathology Physician
  • Rockville, MD
National Provider Identifier
1093708653
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
D66775 Issued in MD
Practice address
1600 E Gude Dr
Ste 200
Rockville, MD 20850-1341
Phone
(301) 978-7489
Fax
(301) 933-7137
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 223046 NY
Anatomic Pathology Physician 207ZP0101X MD456689 PA
Anatomic Pathology Physician 207ZP0101X D0066775 MD
Anatomic Pathology Physician 207ZP0101X D66775 MD Primary

Addresses

Primary practice location

1600 E Gude Dr
Ste 200
Rockville, MD 20850-1341

Mailing address

1600 E Gude Dr
Ste 200
Rockville, MD 20850-1341
Phone (301) 978-7489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0066775MDMDAnatomic Pathology Physician
D66775MDMDAnatomic Pathology Physician
223046NYMDAnatomic Pathology Physician
MD456689PAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Medical Center Pathology Associates Anatomic Pathology PastSince Aug 1, 1991 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1093708653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E GUDE DR",
            "address_2": "STE 200",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501341",
            "telephone_number": "301-978-7489",
            "fax_number": "301-933-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E GUDE DR",
            "address_2": "STE 200",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501341",
            "telephone_number": "301-978-7489",
            "fax_number": "301-933-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "JOON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "223046",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD456689",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MD",
            "license": "D0066775",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MD",
            "license": "D66775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.