Individual provider Active NPI

Michael Seyun Kim

  • Emergency Medicine Physician
  • Springfield, IL
National Provider Identifier
1124478201
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.068557 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62702-3757
Phone
(217) 545-3518
Fax
(217) 545-2711
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01081987A IN
Emergency Medicine Physician 207P00000X 036167682 IL
Emergency Medicine Physician 207P00000X 125.068557 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62702-3757

Mailing address

PO Box 19638
Springfield, IL 62794-9638
Phone (217) 545-3518

Other practice location 1

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240124001354 IL Practitioner - Emergency Medicine 6507150315 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036167682ILMDEmergency Medicine Physician
125.068557ILMDEmergency Medicine Physician
01081987AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Blessing Hospital CurrentSince Feb 1, 2024 Accepting new patients
Blessingcare Corporation Current Accepting new patients
Blessingcare Corporation Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Blessingcare Corporation CurrentSince Jul 1, 2025 Accepting new patients
Blessingcare Corporation CurrentSince Feb 1, 2024 Accepting new patients
Blessing Hospital CurrentSince Feb 1, 2024 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Blessing Hospital Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

1005 Broadway St
Quincy, IL 62301

1206 E National Ave
Brazil, IN 47834
Phone (812) 442-2480

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890

301 Henry St
North Vernon, IN 47265
Phone (812) 352-4200

2412 E Main St
Plainfield, IN 46168
Phone (317) 204-6800

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 10

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 2

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1124478201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19638",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949638",
            "telephone_number": "217-545-3518",
            "fax_number": "217-545-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023757",
            "telephone_number": "217-545-3518",
            "fax_number": "217-545-2711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012834",
            "country_code": "US",
            "telephone_number": "217-223-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "SEYUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01081987A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036167682",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.068557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.