Individual provider Active NPI

Eric G Kim, DO

  • Orthopaedic Surgery Physician
  • St Augustine, FL
National Provider Identifier
1124463088
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS15986 Issued in FL
Practice address
45 Groover Loop Ste 201
St Augustine, FL 32086-6586
Phone
(904) 634-0640
Fax
(904) 634-0203
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OTO15084 PA
Orthopaedic Surgery Physician 207X00000X OS15986 FL Primary

Addresses

Primary practice location

45 Groover Loop Ste 201
St Augustine, FL 32086-6586

Mailing address

6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0640

Other practice location 1

2627 Riverside Ave Ste 300
Jacksonville, FL 32204-4717
Phone (904) 634-0640

Other practice location 2

2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone (904) 328-5979

Other practice location 3

2300 Park Ave Ste 206
Orange Park, FL 32073-5573
Phone (904) 634-0640

Other practice location 4

4268 Oldfield Crossing Dr Ste 201
Jacksonville, FL 32223-8800
Phone (904) 634-0640

Other practice location 5

3055 County Road 210 W Ste 110
Saint Johns, FL 32259-7001
Phone (904) 634-0640

Other practice location 6

232 Ponte Vedra Park Dr
Ponte Vedra, FL 32082-6600
Phone (904) 634-0640

Other practice location 7

1690 US Highway 1 S Ste F
St Augustine, FL 32084-6024
Phone (904) 634-0640

Other practice location 8

216 Southpark Cir E Ste 216
St Augustine, FL 32086-5135
Phone (904) 634-0640

Other practice location 9

15255 Max Legget Pkwy Ste 5300
Jacksonville, FL 32218-7274
Phone (904) 634-0640

Other practice location 10

10475 Centurion Pkwy N Ste 220
Jacksonville, FL 32256-5004
Phone (904) 634-0640

Other practice location 11

4565 US Highway 17 Ste 200
Fleming Island, FL 32003-4823
Phone (904) 634-0640

Other identifiers 1

IdentifierTypeStateIssuer
108757500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL drheekin@direct.heekinclinic.nextshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 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
I20181002001734 CA Practitioner - Orthopedic Surgery 3375820947 Reassigns benefits to 1 organization
I20190725003208 FL Practitioner - Orthopedic Surgery 3375820947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Orthopedic Specialists LLCGroup PAC ID 1456246974, 144 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

10475 Centurion Pkwy N
Jacksonville, FL 32256-5004
Phone (904) 634-0640

1200 Lexington Green LN
Sanford, FL 32771-1013

2110 Herschel St
Jacksonville, FL 32204-3820
Phone (904) 634-0640

232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 634-0640

2627 Riverside Ave
FL 3
Jacksonville, FL 32204-4717
Phone (904) 634-0640

300 Saint Elizabeth Way
Suite 210
St Johns, FL 32259-1153
Phone (904) 634-0640

3055 County Rd 210
Suite 110
St Johns, FL 32259-7001
Phone (904) 634-0640

4268 Oldfield Crossing Dr
Suite 201
Jacksonville, FL 32223-8800
Phone (904) 634-0640

45 Groover Loop
St Augustine, FL 32086-6586
Phone (904) 634-0640

Hospital & facility affiliations

  • Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score
90.75 of 100Reported as group
Quality
88.19
Promoting interoperability
100
Improvement activities
40
Cost
80.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement46
Knee replacement100
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OTO15084PAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Southeast Orthopedic Specialists, LLC Orthopaedic Surgery CurrentSince Nov 1, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 22, 2018 Accepting new patients
Southeast Orthopedic Specialists, LLC Orthopaedic Surgery CurrentSince Nov 1, 2020 Accepting new patients
Kim Orthopedic LLC Current Accepting new patients
Center for Orthopedic Research and Education, LLC Orthopaedic Surgery Past Accepting new patients

Locations

3850 G St
Merced, CA 95340
Phone (209) 384-6528

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4565 US Highway 17
Ste 200
Fleming Island, FL 32003
Phone (904) 630-0640

2 Shircliff Way
Ste 605
Jacksonville, FL 32204
Phone (904) 328-5979

6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216

10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014

4268 Oldfield Crossing Dr
Ste 201
Jacksonville, FL 32223
Phone (904) 630-0640

2627 Riverside Ave
Ste 300
Jacksonville, FL 32204
Phone (904) 634-0460

15255 Max Leggett Pkwy
Ste 5300
Jacksonville, FL 32218
Phone (904) 203-1386

2300 Park Ave
Ste 206
Orange Park, FL 32073
Phone (904) 278-4274

232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-7546

216 Southpark Cir E
Ste 216
St Augustine, FL 32086
Phone (904) 634-0203

45 Groover Loop
Unit 201
St Augustine, FL 32086
Phone (904) 634-0604

1690 US Highway 1 S
Ste F
St Augustine Beach, FL 32084
Phone (904) 634-0460

300 Saint Elizabeth Way
Ste 210
St Johns, FL 32259
Phone (904) 691-9200

3055 County Road 210 W
Ste 110
St Johns, FL 32259
Phone (904) 825-0540

Interoperability endpoints

  • Direct secure messaging: eric.kim.1@22724.direct.athenahealth.com

Organizations & group practices 6

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 9

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": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1124463088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GROOVER LOOP STE 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866586",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2627 Riverside Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044717",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Shircliff Way Ste 605",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044762",
            "country_code": "US",
            "telephone_number": "904-328-5979",
            "fax_number": "904-619-9925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Park Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735573",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4268 Oldfield Crossing Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238800",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3055 County Road 210 W Ste 110",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "FL",
            "postal_code": "322597001",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Ponte Vedra Park Dr",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra",
            "state": "FL",
            "postal_code": "320826600",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 US Highway 1 S Ste F",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320846024",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Southpark Cir E Ste 216",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865135",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 Max Legget Pkwy Ste 5300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187274",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10475 Centurion Pkwy N Ste 220",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322565004",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4565 US Highway 17 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034823",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ERIC",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OTO15084",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS15986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108757500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drheekin@direct.heekinclinic.nextshare.com",
            "affiliation": "N",
            "endpointDescription": "connect url",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Shircliff Way",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322044753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.