Individual provider Active NPI

Preston Y Kim, M.D.

  • Gastroenterology Physician
  • Columbia, MD
National Provider Identifier
1194715391
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D0062386 Issued in MD
Practice address
10710 Charter Dr
Suite 110
Columbia, MD 21044-3258
Phone
(410) 992-9797
Fax
(410) 730-0942
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0062386 MD Primary

Addresses

Primary practice location

10710 Charter Dr
Suite 110
Columbia, MD 21044-3258

Mailing address

10710 Charter Dr
Suite 110
Columbia, MD 21044-3258
Phone (410) 992-9797

Other identifiers 1

IdentifierTypeStateIssuer
007080700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20051031000160 MD Practitioner - Gastroenterology 3173540051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Virginia Commonwealth University, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesapeake Digestive Associates, PCGroup PAC ID 5597151357, 38 clinicians

Practice addresses (Care Compare)

10710 Charter Dr
Suite 110
Columbia, MD 21044-3258
Phone (410) 992-9797

621 Ridgely Ave
Suite 201
Annapolis, MD 21401-1083
Phone 4102244887421

700 Geipe Rd
Suite 230
Catonsville, MD 21228-4176
Phone (410) 247-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.3 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
74.35

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
59.44
Promoting interoperability
97
Improvement activities
40
Cost
81.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy224
Upper gastrointestinal (GI) endoscopy for acid reflux190

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062386MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Digestive Associates, PC Gastroenterology CurrentSince Sep 21, 2022 Accepting new patients
Digestive Disease Associates, LLC Gastroenterology CurrentSince Nov 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

621 Ridgely Ave
Ste 201
Annapolis, MD 21401
Phone (410) 224-4887

700 Geipe Rd
Ste 230
Catonsville, MD 21228

700 Geipe Rd
Ste 203
Catonsville, MD 21228
Phone (410) 368-8725

700 Geipe Rd
Ste 201
Catonsville, MD 21228

10710 Charter Dr
Ste 110
Columbia, MD 21044
Phone (410) 992-9797

1220C E Joppa Rd
Ste 508
Towson, MD 21286
Phone (410) 296-4415

Interoperability endpoints

  • Direct secure messaging: preston.kim@gastrohealth.eclinicaldirectplus.com
  • Direct secure messaging: pkim52579@direct.hopkinsmedicine.org

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1194715391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443258",
            "telephone_number": "410-992-9797",
            "fax_number": "410-730-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443258",
            "telephone_number": "410-992-9797",
            "fax_number": "410-730-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PRESTON",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0062386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007080700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.