Individual provider Active NPI

Samuel Hyojune Kim, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Alexandria, VA
National Provider Identifier
1174889141
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
0101264321 Issued in VA
Practice address
2501 Parkers LN
Alexandria, VA 22306-3209
Phone
(703) 664-7000
Fax
(703) 664-7666
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 286789 NY
Emergency Medicine Physician 207P00000X 0101264321 VA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101264321 VA Primary

Addresses

Primary practice location

2501 Parkers LN
Alexandria, VA 22306-3209

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

One Gustave L Levy Place, Box 1264
Mount Sinai Medical Center Box 1264
New York, NY 10029
Phone (212) 241-8867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20180709000456 DC Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 6507098902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Emergency Medicine
Education
University of Virginia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

8503 Arlington Blvd
Fairfax, VA 22031-4628
Phone (703) 970-2670

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Emergency Physicians PC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Inova Health Care Services Critical Care Medicine CurrentSince Jan 1, 2021 Accepting new patients
Commonwealth Emergency Physicians PC Past Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

22505 Landmark Ct
Ashburn, VA 20148
Phone (571) 472-6464

8503 Arlington Blvd
Fairfax, VA 22031
Phone (703) 970-2670

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

224 Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

9321 Sanger St
Lorton, VA 22079
Phone (703) 982-8324

Organizations & group practices 3

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 2

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1174889141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PARKERS LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063209",
            "telephone_number": "703-664-7000",
            "fax_number": "703-664-7666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Gustave L Levy Place, Box 1264",
            "address_2": "Mount Sinai Medical Center Box 1264",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10029",
            "country_code": "US",
            "telephone_number": "212-241-8867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SAMUEL",
        "middle_name": "HYOJUNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2022-03-31",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "286789",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101264321",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101264321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.