Individual provider Active NPI

Chee Gap Kim, MD

  • Rehabilitation Practitioner
  • Englewood, NJ
National Provider Identifier
1093723314
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
51283 Issued in NJ
Practice address
535 Grand Ave
Second Floor
Englewood, NJ 07631-4934
Phone
(201) 541-1111
Fax
(201) 541-0777
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 51283 NJ Primary

Addresses

Primary practice location

535 Grand Ave
Second Floor
Englewood, NJ 07631-4934

Mailing address

535 Grand Ave
Second Floor
Englewood, NJ 07631-4934
Phone (201) 541-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20070614000114 NJ Practitioner - Physical Medicine and Rehabilitation 0648378653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

535 Grand Ave
Englewood, NJ 07631-4934

Merit-based Incentive Payment System (MIPS)

Final score
26.32 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
87.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51283NJMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Home Adult Day Care, LLC CurrentSince Apr 20, 2019 Accepting new patients

Locations

475 Grand Ave
Fl 2
Englewood, NJ 07631
Phone (201) 541-1111

535 Grand Ave
#2
Englewood, NJ 07631
Phone (201) 541-1111

475 Grand Ave
Englewood, NJ 07631
Phone (201) 871-4545

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093723314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 GRAND AVE",
            "address_2": "SECOND FLOOR",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314934",
            "telephone_number": "201-541-1111",
            "fax_number": "201-541-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 GRAND AVE",
            "address_2": "SECOND FLOOR",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314934",
            "telephone_number": "201-541-1111",
            "fax_number": "201-541-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHEE",
        "middle_name": "GAP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NJ",
            "license": "51283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.