Individual provider Active NPI

Edward C Kim, MD

  • Gastroenterology Physician
  • Manassas, VA
National Provider Identifier
1275538076
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101045874 Issued in VA
Practice address
8640 Sudley Rd Ste 201
Manassas, VA 20110-4404
Phone
(703) 368-6819
Fax
(703) 330-2923
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101045874 VA Primary

Addresses

Primary practice location

8640 Sudley Rd Ste 201
Manassas, VA 20110-4404

Mailing address

PO Box 381468
Germantown, TN 38183-1468

Other practice location 1

7915 Lake Manassas Dr Ste 302
Gainesville, VA 20155-3260
Phone (571) 248-0653

Other practice location 2

170 W Shirley Ave Ste 205
Warrenton, VA 20186-3083
Phone (540) 347-2470

Other identifiers 2

IdentifierTypeStateIssuer
1275538076MedicaidVA
005847052MedicaidVA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110215001133 VA Practitioner - Gastroenterology 2466470265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Jefferson Medical College of Thomas Jefferson University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Associates VA, LLCGroup PAC ID 2466449228, 51 clinicians

Practice addresses (Care Compare)

8640 Sudley Rd
Suite 201
Manassas, VA 20110-4404
Phone (703) 368-6819

Hospital & facility affiliations

  • Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
  • Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
  • Fauquier Hospital Hospital, Warrenton, VA, CCN 490023

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy84
Upper gastrointestinal (GI) endoscopy for acid reflux60

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates VA, LLC Gastroenterology CurrentSince Sep 30, 1999 Accepting new patients

Locations

7915 Lake Manassas Dr
Ste 302
Gainesville, VA 20155
Phone (571) 248-0653

8640 Sudley Rd
Ste 201
Manassas, VA 20110
Phone (703) 368-6819

170 W Shirley Ave
Ste 205
Warrenton, VA 20186
Phone (540) 347-2470

Organizations & group practices 1

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 3

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1275538076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 SUDLEY RD STE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104404",
            "telephone_number": "703-368-6819",
            "fax_number": "703-330-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7915 Lake Manassas Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201553260",
            "country_code": "US",
            "telephone_number": "571-248-0653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 W Shirley Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "VA",
            "postal_code": "201863083",
            "country_code": "US",
            "telephone_number": "540-347-2470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101045874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275538076",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005847052",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.