Organization Active NPI

Hwaok Kim MD PLLC

  • Internal Medicine Physician
  • Rochester, NY
National Provider Identifier
1215173760
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
208136 Issued in NY
Legal business name
HWAOK KIM MD PLLC
Practice address
2735 Buffalo Rd
Suite 1
Rochester, NY 14624-1337
Phone
(585) 436-1620
Fax
(585) 527-9049
NPI assigned
Jan 5, 2009
Last updated
Oct 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Dr. Hwaok Kim, M.D.NPI 1356308043
Title
Doctor/Doctor
Phone
(585) 436-1620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 208136 NY Primary

Addresses

Primary practice location

2735 Buffalo Rd
Suite 1
Rochester, NY 14624-1337

Mailing address

2735 Buffalo Rd
Suite 1
Rochester, NY 14624-1337
Phone (585) 436-1620

Other identifiers 4

IdentifierTypeStateIssuer
101727BJOtherNYMVP/PREFERRED CARE
P01020836OtherNYEXCELLUS BLUE CROSS/BLUE SHIELD
03118870MedicaidNY
P020208136OtherNYEXCELLUS HMO'S

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090225000206 NY Part B Supplier - Clinic/Group Practice 5698831782 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

2735 Buffalo Rd
Ste 1
Rochester, NY 14624
Phone (585) 436-1620

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1215173760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 BUFFALO RD",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241337",
            "telephone_number": "585-436-1620",
            "fax_number": "585-527-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 BUFFALO RD",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241337",
            "telephone_number": "585-436-1620",
            "fax_number": "585-527-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HWAOK KIM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HWAOK",
        "authorized_official_title_or_position": "DOCTOR/DOCTOR",
        "authorized_official_telephone_number": "585-436-1620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP/PREFERRED CARE",
            "identifier": "101727BJ",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BLUE CROSS/BLUE SHIELD",
            "identifier": "P01020836",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03118870",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS HMO'S",
            "identifier": "P020208136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.