NPIMap

Individual provider Active NPI

Derek Taeyoung Kim

  • Vascular & Interventional Radiology Physician
  • Silver Spring, MD
National Provider Identifier
1225533045
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
D0100497 Issued in MD
Practice address
1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone
(301) 754-7000
NPI assigned
Mar 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0100497 MD
Vascular & Interventional Radiology Physician 2085R0204X D0100497 MD Primary

Addresses

Primary practice location

1500 Forest Glen Rd
Silver Spring, MD 20910-1460

Mailing address

1500 Forest Glen Rd
Silver Spring, MD 20910-1460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240527000047 DC Practitioner - Interventional Radiology 1153763826 Reassigns benefits to 2 organizations
I20250305001330 VA Practitioner - Diagnostic Radiology 1153763826 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winchester Radiologists PCGroup PAC ID 7113915281, 77 clinicians

Practice addresses (Care Compare)

1500 Forest Glen Rd
Silver Spring, MD 20910-1460
Phone (301) 754-7000

4885 Edgemoor LN
Apt 1504
Bethesda, MD 20814-5592
Phone (540) 686-1600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Page Memorial Hospital, Inc. Current Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Professional Services of Holy Cross CurrentSince May 20, 2024 Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Professional Services of Holy Cross CurrentSince May 20, 2024 Accepting new patients
Warren Memorial Hospital, Inc. Current Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Winchester Radiologists PC Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Page Memorial Hospital Inc. Past Accepting new patients

Locations

19801 Observation Dr
Germantown, MD 20876
Phone (301) 557-5928

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

9166 N Congress St
New Market, VA 22844
Phone (540) 459-1340

235 Medical Dr
Stanley, VA 22851
Phone (540) 778-3484

220 Campus Blvd
Ste 320
Winchester, VA 22601

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

160 Exeter Dr
Ste 103
Winchester, VA 22603
Phone (541) 686-1600

240 Shenandoah St
Woodstock, VA 22664
Phone (540) 459-2808

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

Organizations & group practices 12

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 7

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": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1225533045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 FOREST GLEN RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FOREST GLEN RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101460",
            "telephone_number": "301-754-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DEREK",
        "middle_name": "TAEYOUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-25",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0100497",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D0100497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.