Keith Chae Kim, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME88949 Issued in FL

Practice address

410 Celebration PL
Suite 401
Celebration, FL 34747-5433

Phone

(407) 303-4658

Fax

(407) 303-4189

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• First Coast Health Ventures, LLC

  dba River City Rehab Center

  • Skilled Nursing Facility
  • Jacksonville, FL
  • NPI 1578199303

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership

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.

• Osceola Surgical Associates LLC

  • Surgery Physician
  • Kissimmee, FL
  • NPI 1578723540
  Medicare reassignment NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1194732750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL",
            "address_2": "SUITE 401",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "407-303-4658",
            "fax_number": "407-303-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL",
            "address_2": "SUITE 401",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "407-303-4658",
            "fax_number": "407-303-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEITH",
        "middle_name": "CHAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME88949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilaree F Kasper, PA-C
• Keiler Heberto Moreno Rivero, P.a. (Moreno's Internal Medicine)
• William Michael Kelley, R.C.E.P.
• Kay Thi Khine
• Kieran Surgical, LLC
• Silvia Kim, PHARM.D.
• Kindbody of FL Medical Practice PA
• Kimberly Kirschner, LDN
• Danielle Kleinberg
• Alexander Matthieus Knops, MD

• Surgery Physician in Celebration, FL
• Providers in Celebration, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.