Justin M Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6310T Issued in TX

Practice address

130 Norris LN
Boerne, TX 78006-2893

Phone

(830) 249-3898

Fax

(830) 249-9228

NPI assigned

Aug 24, 2005

Last updated

Apr 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment Care Compare group NPD
• Trinity Vision Center,PA

  • Optometrist
  • Boerne, TX
  • NPI 1861694549
  Authorized official Same address or phone
• Janet B Ogletree OD PA

  dba Ogletree Eye Care

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Texas Southwestern Medical Center at Dallas

  dba UT Southwestern University Hospital

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1285798918
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1194718114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NORRIS LN",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062893",
            "telephone_number": "830-249-3898",
            "fax_number": "830-249-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NORRIS LN",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062893",
            "telephone_number": "830-249-3898",
            "fax_number": "830-249-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6310T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall County (Kendall County EMS)
• Kendall Implant and Oral Surgery
• Kennell Family Chiropractic PA
• James F Kennell
• Ket Home Care Incorporated (Always Best Care)
• Amanda King, LPC-A
• Alexis Kirby, LVN
• KKG Senior Care, LLC
• Christopher D. Knippa
• Michael Konopacki, M.D.

• Optometrist in Boerne, TX
• Providers in Boerne, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.