Individual provider Active NPI

Heung B Kim, MD

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1144249632
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
204858 Issued in MA
Practice address
300 Longwood Ave
Fegan 3
Boston, MA 02115-5724
Phone
(617) 355-8544
Fax
(617) 730-0477
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 204858 MA
Surgery Physician 208600000X 204858 MA Primary
Pediatric Surgery Physician 2086S0120X 204858 MA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 204858 MA

Addresses

Primary practice location

300 Longwood Ave
Fegan 3
Boston, MA 02115-5724

Mailing address

510 North Ave
Weston, MA 02493-1806
Phone (781) 647-9861

Other identifiers 1

IdentifierTypeStateIssuer
0199958MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20120225000116 MA Practitioner - General SurgeryPractitioner - Pediatric Medicine 9537327259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Pediatric Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHMC Surgical Foundation IncGroup PAC ID 7012016488, 28 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204858MAMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Surgical Foundation Inc CurrentSince Aug 14, 2002 Accepting new patients
Children'S Hospital Corporation Past Accepting new patients
Dana-Farber Cancer Institute, Inc. Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
#3
Boston, MA 02115
Phone (617) 355-7737

Interoperability endpoints

  • Direct secure messaging: hkim88825@tuftsmedicine.direct-ci.com

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1144249632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NORTH AVE",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931806",
            "telephone_number": "781-647-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "FEGAN 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-8544",
            "fax_number": "617-730-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEUNG",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "MA",
            "license": "204858",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "204858",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MA",
            "license": "204858",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "204858",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199958",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.