Individual provider Active NPI

Phillip Kim

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1194258301
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD479690 Issued in PA
Practice address
111 S 11TH St
Philadelphia, PA 19107-4824
Phone
(215) 955-6000
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X MD479690 PA Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St
Philadelphia, PA 19107-4824
Phone (215) 955-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230914002115 PA Practitioner - Diagnostic Radiology 5395109938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
George Washington University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Imaging of Lehigh Valley PCGroup PAC ID 1557265212, 115 clinicians
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Phone (610) 770-1606

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Lehigh Valley Hospital - Macungie Hospital, Macungie, PA, CCN 390430

Merit-based Incentive Payment System (MIPS)

Final score
76.81 of 100Reported as group
Quality
75.84
Improvement activities
40
Cost
66.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD479690PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging of Lehigh Valley PC Diagnostic Radiology CurrentSince Aug 1, 2023 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 1, 2025 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 1, 2025 Accepting new patients
Scranton Hospitalist Physician Services LLC Diagnostic Radiology PastSince May 7, 2025 Accepting new patients
Lehigh Valley Diagnostic Imaging Past Accepting new patients

Locations (25 of 66)

1230 S Cedar Crest Blvd
Ste 104
Allentown, PA 18103
Phone (610) 402-1070

2100 Mack Blvd
Fl 4
Allentown, PA 18103

4815 W Tilghman St
Allentown, PA 18104
Phone (610) 402-3903

1250 S Cedar Crest Blvd
Ste 100
Allentown, PA 18103
Phone (610) 435-1600

1243 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 402-9230

1621 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 402-3300

1220 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 740-0400

1230 S Cedar Crest Blvd
Ste 103
Allentown, PA 18103
Phone (610) 402-4691

1240 S Cedar Crest Blvd
Ste 203
Allentown, PA 18103
Phone (610) 402-0690

1247 S Cedar Crest Blvd
Ste 102
Allentown, PA 18103
Phone (610) 402-1022

1503 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 871-9110

798 Hausman Rd
Allentown, PA 18104
Phone (610) 530-1515

1791 Airport Rd
Allentown, PA 18109
Phone (484) 240-8195

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 435-1003

1230 S Cedar Crest Blvd
Ste 202
Allentown, PA 18103
Phone (610) 402-4691

1255 S Cedar Crest Blvd
Ste 2600
Allentown, PA 18103

1405 N Cedar Crest Blvd
Ste 200
Allentown, PA 18104
Phone (610) 402-8378

250 Cetronia Rd
Ste 101
Allentown, PA 18104
Phone (610) 674-4941

1101 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 240-4073

1255 S Cedar Crest Blvd
Ste 2500
Allentown, PA 18103
Phone 6103724957550

6649 Chrisphalt Dr
Bath, PA 18014
Phone (610) 837-3181

2101 Emrick Blvd
Bethlehem, PA 18020
Phone (484) 895-3300

2597 Schoenersville Rd
Ste 202
Bethlehem, PA 18017
Phone (484) 884-2460

1770 Bathgate Rd
Ste 100
Bethlehem, PA 18017
Phone (484) 884-1032

Interoperability endpoints

  • Direct secure messaging: pkim812279@direct2.lvhn.org

Organizations & group practices 7

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 11

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1194258301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PHILLIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD479690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.