Individual provider Active NPI

William Kim, M.D.

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1306284179
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
256141 Issued in MA
Practice address
860 Washington St
Boston, MA 02111-1521
Phone
(617) 636-5496
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 256141 MA Primary

Addresses

Primary practice location

860 Washington St
Boston, MA 02111-1521

Mailing address

3801 University Dr
Ste 300
Fairfax, VA 22030-2503
Phone (703) 383-8130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20180905000124 DC Practitioner - Otolaryngology 4183923782 Reassigns benefits to 2 organizations
I20181003003046 VA Practitioner - Otolaryngology 4183923782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tufts University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Otolaryngology Associates PCGroup PAC ID 8022188069, 31 clinicians

Practice addresses (Care Compare)

24805 Pinebrook Rd
Suite 201
Chantilly, VA 20152-4128
Phone (703) 383-8130

3801 University Dr
Suite 300
Fairfax, VA 22030-2503
Phone (703) 383-8130

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Melanoma (skin cancer) excision25
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology Associates, PC Otolaryngology CurrentSince Sep 1, 2018 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

24805 Pinebrook Rd
Ste 201
Chantilly, VA 20152
Phone (703) 327-4900

3801 University Dr
#200
Fairfax, VA 22030

3801 University Dr
#300
Fairfax, VA 22030
Phone (703) 383-8130

3801 University Dr
Ste 300
Fairfax, VA 22030
Phone (703) 383-8130

3801 University Dr
Fl 3
Fairfax, VA 22030
Phone (703) 383-8130

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

1850 Town Center Pkwy
Ste 305
Reston, VA 20190
Phone (703) 834-2900

1850 Town Center Pkwy
#305
Reston, VA 20190
Phone (703) 834-2900

24805 Pinebrook Rd
South Riding, VA 20152
Phone (727) 255-3575

Organizations & group practices 5

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1306284179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 UNIVERSITY DR",
            "address_2": "STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302503",
            "telephone_number": "703-383-8130",
            "fax_number": "703-383-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111521",
            "telephone_number": "617-636-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "256141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.