Individual provider Active NPI

Minjae Kim, M.D.

  • Anesthesiology Physician
  • Atlanta, GA
National Provider Identifier
1104068725
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
104644 Issued in GA
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone
(404) 351-1745
NPI assigned
Mar 27, 2009
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 246726-1 NY
Anesthesiology Physician 207L00000X 104644 GA Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Mailing address

622 W 168TH St
PH5-505C
New York, NY 10032-3720

Other practice location 1

622 W 168th St
PH5-133
New York, NY 10032-3720
Phone (212) 305-3226

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address mik9046@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110718000466 NY Practitioner - Anesthesiology 3779751748 Reassigns benefits to 2 organizations
I20250919001177 GA Practitioner - Anesthesiology 3779751748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 351-1745

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104644GAMDAnesthesiology Physician
246726-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2018 Accepting new patients
Piedmont Anesthesia LLC Anesthesiology CurrentSince Aug 1, 2025 Accepting new patients
Trustees of Columbia University in the City of New York Anesthesiology CurrentSince Jul 1, 2011 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 3303
New York, NY 10032
Phone (212) 305-2654

622 W 168th St
Ph 5133
New York, NY 10032
Phone (212) 305-3226

622 W 168th St
Ph 5505
New York, NY 10032
Phone (212) 305-6494

622 W 168th St
Ph 5505C
New York, NY 10032
Phone (212) 305-9876

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 4

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 3

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1104068725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "PH5-505C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-351-1745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "622 W 168th St",
            "address_2": "PH5-133",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323720",
            "country_code": "US",
            "telephone_number": "212-305-3226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINJAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "246726-1",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "104644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "622 W 168th St",
            "address_2": "PH5-133",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "622 W 168th St",
            "address_2": "PH5-133",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mik9046@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "622 W 168th St",
            "address_2": "PH5-133",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.