Chong M. Kim, MD
Individual provider Active NPI Urology Physician · Cape May Court House, NJ
NPI 1295750701 · NPPES record last updated May 18, 2018
Key facts
- NPI
- 1295750701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 25MA09395500 (NJ)
- Practice address
- 217 N Main St Ste 104
Cape May Court House, NJ 08210 - Phone
- (609) 463-1488
- Fax
- (609) 463-4881
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080206000271 | NY | Practitioner - Urology | 7911929419 | Reassigns benefits to 1 organization |
| I20140728001526 | NJ | Practitioner - Urology | 7911929419 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09395500 | NJ | MD | Urology Physician |
| MD426470 | PA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physicians P C | Urology | Current |
Accepting new patients |
| Atlantic Coast Urology,PA | Urology | Current |
Accepting new patients |
| Adult & Pediatric Urology of Hunterdon, PA | Urology | Current |
Accepting new patients |
| Holzer Clinic, LLC | Past | Accepting new patients | |
| Robert Wood Johnson Physician Enterprise | Past |
Accepting new patients |
Locations
5 Walter E Foran Blvd
Ste 4001
Flemington, NJ 08822
Phone (908) 751-5939
1944 Corlies Ave
Ste 101
Neptune, NJ 07753
Phone (732) 775-8444
6915 Yellowstone Blvd
Ste 4
Forest Hills, NY 11375
Phone (718) 360-9550
800 2nd Ave
New York, NY 10017
Phone (646) 918-7363
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 207433 | NY | |
| Urology Physician | 208800000X | MD426470 | PA | |
| Urology Physician | 208800000X | 25MA09395500 | NJ | Yes |
Addresses
Primary practice location
217 N Main St Ste 104
Cape May Court House, NJ 08210
Mailing address
PO Box 593
Cape May Court House, NJ 08210-0593
Phone (609) 463-2755
Other practice location 1
234 E 149th St
Suite 2A7
Bronx, NY 10451-5504
Phone (917) 409-7552
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MA09395500 | Other | NJ | NJ STATE LICENSE |
Other providers in Cape May Court House, NJ
- Joseph Patrick Kelly
- Maura Kelly
- Susan Marie Kemenosh
- Olivia Kennedy-Sharayko
- Charles Kim
- Diana Klitz
- Judi B Knupp
- Henry J Komansky
- Eric Konczyk
- Joseph Raymond Krafft
All providers in Cape May Court House, NJ · Urology Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.