Individual provider Active NPI

Yong S Kim, M.D.

  • Family Medicine Physician
  • Snellville, GA
National Provider Identifier
1164452942
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
046142 Issued in GA
Practice address
1742 Oak Rd
Snellville, GA 30078-2234
Phone
(770) 638-1401
Fax
(770) 638-1402
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 046142 GA Primary

Addresses

Primary practice location

1742 Oak Rd
Snellville, GA 30078-2234

Mailing address

1742 Oak Rd
Snellville, GA 30078-2234
Phone (770) 638-1401

Other identifiers 1

IdentifierTypeStateIssuer
000803536GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040518000642 GA Practitioner - Family Practice 3779573928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Emory University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

966 A Killian Hill Rd SW
Lilburn, GA 30047-3102
Phone (770) 923-4815

Hospital & facility affiliations

  • Accentcare Home Health of Northeast Georgia Home health agency, Buford, GA, CCN 117139
  • Central Home Health Care, an Amedisys Company Home health agency, Tucker, GA, CCN 117026
  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046142GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1776 Old Spring House Ln
Atlanta, GA 30338
Phone (770) 454-0091

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1742 Oak Rd
Snellville, GA 30078
Phone (770) 638-1401

Interoperability endpoints

  • Direct secure messaging: ykim20146@direct.emory.org

Organizations & group practices 2

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 4

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1164452942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 OAK RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782234",
            "telephone_number": "770-638-1401",
            "fax_number": "770-638-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 OAK RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782234",
            "telephone_number": "770-638-1401",
            "fax_number": "770-638-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YONG",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "046142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000803536G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.