Theodore Y Kim, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

D0033979 Issued in MD

Practice address

7350 Van Dusen Rd
Ste 210
Laurel, MD 20707-5268

Phone

(301) 498-5500

Fax

(301) 498-7346

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in DC, MD2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theodore.kim.capitaldigestivecare@directaddress.net

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.

• Capital Digestive Care LLC

  • Gastroenterology Physician
  • Silver Spring, MD
  • NPI 1164683181

  DC

  Medicare reassignment NPD
• Capital Digestive Care, LLC

  • Gastroenterology Physician
  • Temple Hills, MD
  • NPI 1437997988
  NPD
• Endoscopy Center of Washington DC LP

  • Ambulatory Surgical Clinic/Center
  • Washington, DC
  • NPI 1154301240
  NPD
• David a. Morowitz

  • Gastroenterology Physician
  • Chevy Chase, MD
  • NPI 1508280728
  NPD (past)
• First Class Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Chevy Chase, MD
  • NPI 1043524671
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Laurel MD Endoscopy ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Laurel, MD
  • NPI 1609871680
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1275538845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 PROSPERITY DR",
            "address_2": "STE 200",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041663",
            "telephone_number": "240-485-5200",
            "fax_number": "301-625-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD",
            "address_2": "STE 210",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075268",
            "telephone_number": "301-498-5500",
            "fax_number": "301-498-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "THEODORE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0033979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00679066",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BSMD",
            "identifier": "531224-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC/MD",
            "identifier": "N5630029",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS DC",
            "identifier": "A1110003",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS DC",
            "identifier": "A1130004",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275761300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BSDC",
            "identifier": "2516-0002",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "10040326",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadia Khoury, DPT
• Da Rye Kim, L.AC
• John Nyun Kim, DDS
• Scott Seung Young Kim, DMD, MD
• Sung Joo Kim, D.M.D
• Symphorian Mbunwe Kimbi, HHA
• Darla Kimbrough-Glears, SLP
• Michael Hunter Kime, DPT
• Kindermender Laurel
• Kinetic Balance Collective

• Gastroenterology Physician in Laurel, MD
• Providers in Laurel, MD by specialty
• Gastroenterology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.