Samuel W Kim, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

231881 Issued in NY

Practice address

1 Columbia St
Dra Imaging, PC
Poughkeepsie, NY 12601-3923

Phone

(845) 454-4700

NPI assigned

Oct 10, 2006

Last updated

May 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Diagnostic Radiology

Education

State University of Ny Upstate Medical University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Southside Faculty Medical Affiliates University Faculty Practice CorpGroup PAC ID 5698175933, 224 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
• NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
• Northwell Hospital Glen Cove Hospital, Glen Cove, NY, CCN 330181
• Plainview Hospital Hospital, Plainview, NY, CCN 330331

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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: skim68595@northwell.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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• Southside Faculty Medical Affiliates University Faculty Practice Corp

  • Body Imaging Physician
  • Seaford, NY
  • NPI 1033791058
  Medicare reassignment Care Compare group NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• D.R. Rossi, M.D., P.C.

  dba Elmont Open MRI

  • Diagnostic Radiology Physician
  • Elmont, NY
  • NPI 1356452353
  NPD (past)
• Dra Imaging, PC

  • Diagnostic Radiology Physician
  • Poughkeepsie, NY
  • NPI 1477525061
  NPD (past)
• Island Neurological Associates, P. C.

  • Neurology Physician
  • Plainview, NY
  • NPI 1558490656
  NPD (past)
• North General Physician Services PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1851315337
  NPD (past)
• North Shore Radiology at Glen Cove PC

  • Body Imaging Physician
  • Glen Cove, NY
  • NPI 1003024662
  NPD (past)

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

• Glen Cove Hospital

  • General Acute Care Hospital
  • Glen Cove, NY
  • NPI 1295743060
  Care Compare affiliation
• Huntington Hospital Association

  • General Acute Care Hospital
  • Huntington, NY
  • NPI 1508845322
  Care Compare affiliation
• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation
• Plainview Hospital

  • General Acute Care Hospital
  • Plainview, NY
  • NPI 1083621130
  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1265520779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BITTERSWEET LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421617",
            "telephone_number": "516-263-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLUMBIA ST",
            "address_2": "DRA IMAGING, PC",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013923",
            "telephone_number": "845-454-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "231881",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "231881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02802124",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunil Kumar Khurana, MD
• Jahanzeb Khurshid, MD
• Brendan Todd Kilpatrick, LMSW
• Brandon Kim, MD
• Daniel Kim, MD
• Su Yeon Kim, M.D.
• Mackenzie Shea Kimball, DO, MS
• Ricardo King
• Roy King
• Kingsway Anesthesia PC

• Diagnostic Radiology Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.