Sang Tae C Kim, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L1094 Issued in TX

Practice address

1500 S Coulter St
Suite 6
Amarillo, TX 79106-1791

Phone

(806) 467-9777

Fax

(806) 467-9799

NPI assigned

Aug 30, 2006

Last updated

Mar 23, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

FMC Medical Foundation, Inc.Group PAC ID 9133341795, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Interim Healthcare of Amarillo Home health agency, Amarillo, TX, CCN 459426
• Bsa Hospital Hospital, Amarillo, TX, CCN 450231
• Quail Creek Surgical Hospital Hospital, Amarillo, TX, CCN 450875
• Pampa Regional Medical Center Hospital, Pampa, TX, CCN 451398

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sang.tae.kim.1@33715.direct.athenahealth.com

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.

• FMC Medical Foundation, Inc.

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1104255272
  Medicare reassignment Care Compare group NPD
• Family Medicine Center of Pampa PLLC

  • Family Medicine Physician
  • Pampa, TX
  • NPI 1174556187
  NPD
• Family Medicine Centers Lab L P

  • Clinical Medical Laboratory
  • Amarillo, TX
  • NPI 1972515765
  NPD (past)

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

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation
• Healthcare of West Texas LLC

  dba Excelacare Home Health

  • Home Health Agency
  • Amarillo, TX
  • NPI 1437104221
  Care Compare affiliation
• Physicians Surgical Hospitals, LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1912948845
  Care Compare affiliation
• Prime Healthcare Services Pampa LLC

  dba Pampa Regional Medical Center

  • Critical Access Hospital
  • Pampa, TX
  • NPI 1700509577
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1144330762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S COULTER ST",
            "address_2": "SUITE 6",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061791",
            "telephone_number": "806-467-9777",
            "fax_number": "806-467-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S COULTER ST",
            "address_2": "SUITE 6",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061791",
            "telephone_number": "806-467-9777",
            "fax_number": "806-467-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANG TAE",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L1094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00794739",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raja Jawad Kiani, M.D.
• Richard Glenn Kibbey III, MD
• Joshua Kilgore, MD
• Tracy M Kilgore, LCSW-S
• Arian Jaye Killebrew, APRN, FNP-BC
• Christina Kimbrell
• Darrell Kimbrough, FNP-C
• Kims DME
• Billie Renae Kincaid
• Kristen A Kinder, OT

• Family Medicine Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.