Individual provider Active NPI

Jin Wan Kim, MD

  • Internal Medicine Physician
  • New Orleans, LA
National Provider Identifier
1114556842
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
337266 Issued in LA
Practice address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone
(504) 842-0487
NPI assigned
Apr 4, 2020
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 337266 LA Primary

Addresses

Primary practice location

1514 Jefferson Hwy
New Orleans, LA 70121-2429

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

Other practice location 1

6431 Fannin St Ste Msb 1134
Houston, TX 77030-1501
Phone (713) 500-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NY2 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
I20250502001580 LA Practitioner - Internal Medicine 8729433842 Reassigns benefits to 1 organization
I20260123001371 NY Practitioner - Cardiovascular Disease (Cardiology) 8729433842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Southwestern Medical School at Dallas, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1100 Girod St
Apt 9L
New Orleans, LA 70113-1932

1100 Girod St Apt
9L
New Orleans, LA 70113-1190

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
337266LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Internal Medicine CurrentSince Mar 24, 2025 Accepting new patients
Ochsner Clinic LLC CurrentSince Mar 24, 2025 Accepting new patients
Azadeh Beheshtian MD PLLC CurrentSince Dec 31, 2025 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
North Shore-Lij Medical PC Internal Medicine PastSince Dec 31, 2025 Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

6 E 45th St
Fl 9
New York, NY 10017
Phone (347) 558-4094

Organizations & group practices 5

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": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1114556842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-0487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St Ste Msb 1134",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN WAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "337266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.