Individual provider Active NPI

Michael K. Kim, M.D.

  • Family Medicine Physician
  • Stafford, VA
National Provider Identifier
1285836189
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101229869 Issued in VA
Practice address
60 Prosperity LN
Stafford, VA 22556-4605
Phone
(757) 303-9475
NPI assigned
Jun 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101229869 VA Primary

Addresses

Primary practice location

60 Prosperity LN
Stafford, VA 22556-4605

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, 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
I20110216000653 VA Practitioner - Family Practice 6103007604 Reassigns benefits to 1 organization
I20131216000275 DC Practitioner - Family Practice 6103007604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince Dec 17, 2012 Accepting new patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince Dec 17, 2012 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

60 Prosperity Ln
Stafford, VA 22556
Phone (540) 658-2811

Interoperability endpoints

  • Direct secure messaging: vaexchange@patientfirstclinics.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1285836189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700",
            "fax_number": "804-217-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PROSPERITY LN",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225564605",
            "telephone_number": "757-303-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-03",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101229869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "60 Prosperity Ln",
            "city": "Stafford",
            "state": "VA",
            "country_code": "US",
            "postal_code": "225564605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.