NPIMap

Individual provider Active NPI

Regina Y Kim, MD

  • Family Medicine Physician
  • Falmouth, ME
National Provider Identifier
1104906155
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
226532 Issued in NY
Practice address
75 Gray Rd
Falmouth, ME 04105-2010
Phone
(207) 535-1340
Fax
(207) 535-1358
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 226532 NY Primary

Addresses

Primary practice location

75 Gray Rd
Falmouth, ME 04105-2010

Mailing address

Mercy West Falmouth Primary Care
75 Gray Rd
Falmouth, ME 04105
Phone (207) 535-1340

Other identifiers 1

IdentifierTypeStateIssuer
02462628MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151218001175 ME Practitioner - Family Practice 3072531334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

75 Gray Rd
Falmouth, ME 04105-2010
Phone (207) 535-1340

Hospital & facility affiliations

  • Northern Light Home Care & Hospice Home health agency, So Portland, ME, CCN 207020
  • Amedisys Home Health Home health agency, Portland, ME, CCN 207073
  • Andwell Health Partners Hospice, Scarborough, ME, CCN 201511
  • Northern Light Home Care & Hospice Hospice, South Portland, ME, CCN 201502
  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008
  • Mainehealth Maine Medical Center Hospital, Portland, ME, CCN 200009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226532NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 3, 2015 Accepting new patients
Mainehealth CurrentSince Nov 3, 2015 Accepting new patients
Mercy Hospital CurrentSince Nov 3, 2015 Accepting new patients
Mercy Hospital CurrentSince Nov 3, 2015 Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

75 Gray Rd
Falmouth, ME 04105
Phone (207) 525-1340

13 Industrial Park Rd
Saco, ME 04072
Phone (207) 283-8800

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

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 and National Provider Directory roles.

Hospital & facility affiliations 42

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1104906155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MERCY WEST FALMOUTH PRIMARY CARE",
            "address_2": "75 GRAY RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "04105",
            "telephone_number": "207-535-1340",
            "fax_number": "207-535-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 GRAY RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052010",
            "telephone_number": "207-535-1340",
            "fax_number": "207-535-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "REGINA",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "226532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02462628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

Verify at the official NPI Registry.