Peter K Kim, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD18930 Issued in RI

Practice address

455 Toll Gate Rd
Warwick, RI 02886-2759

Phone

(401) 737-7010

Fax

(401) 738-0013

NPI assigned

Aug 23, 2006

Last updated

Jan 9, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK, OR2 enrollments

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 2

Specialty

General Surgery

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Bay Area Hospital DistrictGroup PAC ID 2163331000, 117 clinicians

Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012
• Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: pkim839198@nychhc.direct-ci.com

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.

• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment Care Compare group NPD
• Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
  • NPI 1467446195
  Medicare reassignment Care Compare group NPD
• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1922559558
  Medicare reassignment Care Compare group NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD
• Grande Ronde Hospital, Inc.

  dba Grande Ronde Hospital Urgent Care

  • Rural Health Clinic/Center
  • La Grande, OR
  • NPI 1093296519
  NPD
• Tanana Valley Clinic LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1073081485
  NPD

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation
• Grande Ronde Hospital

  dba Grande Ronde Hospital Childrens Clinic

  • Pediatrics Physician
  • La Grande, OR
  • NPI 1861434615

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital Inc.

  dba Grande Ronde Hospital Womens Clinic

  • Obstetrics & Gynecology Physician
  • La Grande, OR
  • NPI 1972545895

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital, Inc.

  dba Grande Ronde Hospital Internal Medicine Clinic

  • Primary Care Clinic/Center
  • La Grande, OR
  • NPI 1174553929

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
  • NPI 1467446195
  Care Compare affiliation

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1205943511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FIRST ST",
            "address_2": "APT. 312",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108031451",
            "telephone_number": "914-772-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010",
            "fax_number": "401-738-0013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 North Rd",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126011154",
            "country_code": "US",
            "telephone_number": "845-483-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "235272",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "MD18930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine M. Kile, FNP-B.C.
• Jay P Kile, OD
• Paul E Kile, M.D.
• Devin Kiley, PA-C
• Hyon Kyu Kim, DPT
• Wusung Kim
• Emily E Kindschy, LCSW
• King Opticians Inc (Michael P King)
• Ava King-Byrne, DNP, NP-C
• Anna R King, D.O.

• Surgery Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.