Individual provider Active NPI

Euisoo S. Kim, M.D.

  • Anesthesiology Physician
  • Towson, MD
National Provider Identifier
1245214600
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0025504 Issued in MD
Practice address
7620 York Rd
Towson, MD 21204-7508
Phone
(410) 337-1660
NPI assigned
Nov 30, 2005
Last updated
Nov 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0025504 MD Primary

Addresses

Primary practice location

7620 York Rd
Towson, MD 21204-7508

Mailing address

29 Creamery LN
Easton, MD 21601-3137
Phone (410) 819-0710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20080527000067 MD Practitioner - Anesthesiology 3274602685 Reassigns benefits to 4 organizations
I20240313000453 DC Practitioner - Anesthesiology 3274602685 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0025504MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Agnes Healthcare, Inc. Anesthesiology Current Accepting new patients
Global Anesthesia Services LLC Anesthesiology CurrentSince May 1, 2015 Accepting new patients
Francu One LLC CurrentSince Sep 10, 2013 Accepting new patients
St. Agnes Healthcare, Inc. CurrentSince Feb 1, 2015 Accepting new patients
First Colonies Anesthesia Associates, LLC Anesthesiology CurrentSince Jun 1, 2015 Accepting new patients
St Agnes Healthcare Inc CurrentSince Feb 1, 2015 Accepting new patients

Locations

626C Admiral Dr
#324
Annapolis, MD 21401

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

6816 Deerpath Rd
Elkridge, MD 21075
Phone (410) 757-5019

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

308 Hospital Dr
Ste 102
Glen Burnie, MD 21061
Phone (410) 760-8100

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

11210 Old Georgetown Rd
#12202
Rockville, MD 20852
Phone (301) 881-7770

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

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 776-3185

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1245214600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CREAMERY LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013137",
            "telephone_number": "410-819-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 YORK RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047508",
            "telephone_number": "410-337-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUISOO",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0025504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.