NPIMap

Individual provider Active NPI

Paul Young-Chan Kim, D.O.

  • Gastroenterology Physician
  • Wyomissing, PA
National Provider Identifier
1285853887
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS011219 Issued in PA
Practice address
1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002
Phone
(610) 374-4401
Fax
(610) 374-7140
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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 OS011219 PA Primary

Addresses

Primary practice location

1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002

Mailing address

1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002
Phone (610) 374-4401

Other identifiers 1

IdentifierTypeStateIssuer
1019426420003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070601000318 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 2668570482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Gastroenterology Associates of Lancaster, LTD.Group PAC ID 4688575434, 248 clinicians

Practice addresses (Care Compare)

1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002
Phone (610) 374-4401

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy127
Upper gastrointestinal (GI) endoscopy for acid reflux124

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midatlantic Endoscopy LLC Current Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Jul 1, 2019 Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. Gastroenterology CurrentSince Jul 1, 2019 Accepting new patients
Westwyo Services LP PastSince May 1, 2015 Accepting new patients

Locations

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

1011 Reed Ave
Wyomissing, PA 19610
Phone (610) 288-3229

1011 Reed Ave
Ste 300
Wyomissing, PA 19610
Phone (610) 374-4401

1011 Reed Ave
Ste 600
Wyomissing, PA 19610
Phone (610) 288-3229

Interoperability endpoints

  • Direct secure messaging: paulkim@ddal.allscriptsdirect.net

Organizations & group practices 4

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 7

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1285853887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 REED AVE",
            "address_2": "SUITE 300",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102002",
            "telephone_number": "610-374-4401",
            "fax_number": "610-374-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 REED AVE",
            "address_2": "SUITE 300",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102002",
            "telephone_number": "610-374-4401",
            "fax_number": "610-374-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "middle_name": "YOUNG-CHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "OS011219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019426420003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.