Individual provider Active NPI

Edina Sunmi Kim, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1316171879
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036127993 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(312) 996-4020
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036127993 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

1740 W Taylor St
Chicago, IL 60612-7232

Other identifiers 1

IdentifierTypeStateIssuer
036127993OtherILSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130717000462 IL Practitioner - Anesthesiology 6901046853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 16, 2013 Accepting new patients
Board of Trustees of the University of Illinois Anesthesiology CurrentSince Jul 16, 2013 Accepting new patients

Locations

1740 W Taylor St
#3200
Chicago, IL 60612
Phone (312) 996-4021

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

7732 Solutions Ctr
Chicago, IL 60677

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

Interoperability endpoints

  • Direct secure messaging: ekim17178@uihealth.direct-ci.com

Organizations & group practices 3

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 1

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1316171879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDINA",
        "middle_name": "SUNMI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036127993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "036127993",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.