Mitchell Kim, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

25MA11030700 Issued in NJ

Practice address

145 Wyckoff Rd Ste 301
Eatontown, NJ 07724-1887

Phone

(848) 208-5250

Fax

(732) 935-1590

NPI assigned

Mar 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076

Merit-based Incentive Payment System (MIPS)

Final score

98.51 of 100Reported as apm

Quality

84.27

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.51 of 100Reported as apm

Quality

84.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkim47770@epicdirect.rwjbh.org

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment Care Compare group NPD
• Rwjbh Primary Care Services

  • Internal Medicine Physician
  • West Orange, NJ
  • NPI 1265037501

  Family Medicine

  Medicare reassignment NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD

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

• Cooperman Barnabas Medical Center Inc

  • General Acute Care Hospital
  • Livingston, NJ
  • NPI 1396857488
  Care Compare affiliation

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1144752122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 WYCKOFF RD STE 301",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241887",
            "telephone_number": "848-208-5250",
            "fax_number": "732-935-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 WYCKOFF RD STE 301",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241887",
            "telephone_number": "848-208-5250",
            "fax_number": "732-935-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA11030700",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MA11030700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Khulusi, NP
• Kidney Care Centers
• Kidney Life, LLC (Atlantic Artificial Kidney Center)
• Kids Progress LLC
• Krista A Killins, RN
• Tina King, LAC
• Patricia Kirwan
• Kaitlin Kiser
• Daniel Harris Kiss, MD
• Cheyenne Alicia Kitson, COTA

• Sports Medicine (Family Medicine) Physician in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Sports Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.