Individual provider Active NPI

John Kim, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1194388736
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T5148 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2017
Phone
(214) 820-2361
NPI assigned
Apr 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 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 TX
Internal Medicine Physician 207R00000X T5148 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2017

Mailing address

800 Dawnwood
Orange, TX 77632-9212
Phone (940) 300-0855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231209000247 TX Practitioner - Internal Medicine 8224363320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

3410 Worth St
Suite 150
Dallas, TX 75246-2027
Phone (214) 370-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
53.49 of 100Reported as group
Quality
45.59
Promoting interoperability
0
Improvement activities
40
Cost
77.2

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA CurrentSince Dec 1, 2023 Accepting new patients
Texas Oncology PA Current Accepting new patients

Locations

3410 Worth St
Ste 150
Dallas, TX 75246
Phone (214) 370-1000

3500 Gaston Ave
Dallas, TX 75246

7777 Forest Ln
Ste C707
Dallas, TX 75230
Phone (972) 566-3000

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3705 W 15th St
Plano, TX 75075
Phone (972) 867-3577

Interoperability endpoints

  • Direct secure messaging: john.kim@txo.ikm.direct-ci.com

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 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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1194388736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 DAWNWOOD",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776329212",
            "telephone_number": "940-300-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T5148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.