Active NPI
Jason Kim
- Ophthalmology Physician
- Indianapolis, IN
National Provider Identifier
1174028997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01087088A
- Practice address
- 9002 N Meridian St Ste 100
Indianapolis, IN 46260-2301 - Phone
- (317) 844-5530
- NPI assigned
- Mar 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01087088A | IN | Primary |
Addresses
Primary practice location
9002 N Meridian St Ste 100
Indianapolis, IN 46260-2301
Mailing address
9002 N Meridian St Ste 100
Indianapolis, IN 46260-2301
Phone (317) 844-5530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01087088A | IN | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1174028997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9002 N MERIDIAN ST STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602301",
"telephone_number": "317-844-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9002 N MERIDIAN ST STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602301",
"telephone_number": "317-844-5530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-25",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01087088A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.