Individual provider Active NPI

Ronald Kim, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1104076074
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125051774 Issued in IL
Practice address
1900 W Polk St
Chicago, IL 60612-3723
Phone
(312) 864-0060
NPI assigned
Sep 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125051774 IL Primary

Addresses

Primary practice location

1900 W Polk St
Chicago, IL 60612-3723

Mailing address

1944 N Wood St
Chicago, IL 60622-1138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, OR2 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
I20100813000872 AK Practitioner - Emergency Medicine 7911031828 Reassigns benefits to 1 organization
I20160510002528 OR Practitioner - Emergency Medicine 7911031828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Emergency Medicine AssociatesGroup PAC ID 5193639912, 24 clinicians

Practice addresses (Care Compare)

3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 562-2211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.68 of 100Reported as group
Quality
84.45
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125051774ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante CurrentSince Apr 15, 2016 Accepting new patients
Alaska Emergency Medicine Associates Emergency Medicine CurrentSince Jul 1, 2010 Accepting new patients
Asante CurrentSince Apr 15, 2016 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1104076074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 N WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125051774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.