Jisoo Kim

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2022-02860 Issued in NC

Practice address

517 Moye Blvd
Greenville, NC 27834-2849

Phone

(252) 744-2393

Fax

(252) 744-0013

NPI assigned

Apr 27, 2018

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

Medicare fee-for-service enrollment

Enrolled in NC

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

General Surgery

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jisoo.kim@direct.myhealthep.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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD

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

• Pitt County Memorial Hospital Inc

  • General Acute Care Hospital
  • Washington, NC
  • NPI 1780359687
  Care Compare affiliation
• Pitt County Memorial Hospital, Inc

  • General Acute Care Hospital
  • Greenville, NC
  • NPI 1043218944
  Care Compare affiliation

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1154819878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 MOYE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342849",
            "telephone_number": "252-744-2393",
            "fax_number": "252-744-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JISOO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2022-02860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell James Kilpatrick, M.D.
• Byeori Kim, PHARM D
• Cheahee Kim
• Eonsoo Kim
• Jessica Kim Kim, D.O.
• Kyle Kim
• Ly Kim, NP
• Miso Kim
• Monica Kimbler
• Jillian Kime, MAED

• Surgery Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.