Active NPI
Phillip Kim, M.D., M.B.A.
- Surgery Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- A158522
- Practice address
- 177 Ft Washingtn Ave # 7GS-313
New York, NY 10032-3733 - Phone
- (212) 305-3038
- NPI assigned
- Apr 7, 2015
- Last updated
- Sep 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A158522 | CA | Primary |
Addresses
Primary practice location
177 Ft Washingtn Ave # 7GS-313
New York, NY 10032-3733
Mailing address
1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-9033
Other practice location 1
69 Jesse Hill Jr. Drive SE
Glenn Memorial Building, 3rd Floor
Atlanta, GA 30303
Phone (404) 251-8915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Harvard Medical School, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-7500
85 Seymour St
Suite 415
Hartford, CT 06106-5523
Phone (860) 246-2071
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.24 of 100
- Quality
- 73.72
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.22
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A158522 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windham Community Memorial Hospital, Inc. | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists, PLLC | Surgery | Current | Accepting new patients |
| Emory Medical Care Foundation Inc | Surgery | Current | Accepting new patients |
| Hartford Pathology Associates, P.C. | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| Hartford Hospital | Surgery | Current | Accepting new patients |
| The William W Backus Hospital | Current | Accepting new patients | |
| William W Backus Hospital | Current | Accepting new patients | |
| Hartford Hospital | Current | Accepting new patients |
Locations
85 Seymour St
Ste 415
Hartford, CT 06106
Phone (860) 249-2071
326 Washington St
Norwich, CT 06360
Phone (860) 701-0140
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410
2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193
69 Jesse Hill Jr Dr SE
Bldg 3RD
Atlanta, GA 30303
Phone (404) 251-8915
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
Interoperability endpoints
- phillip.kim@xdr.hhchealthdirect.org
- pkim95329@connecticutchildrens.direct-ci.com
Organizations & group practices 10
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
- Surgery Physician
- Hartford, CT
- NPI 1407806391
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- General Acute Care Hospital
- Willimantic, CT
- NPI 1023191467
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- Anatomic Pathology & Clinical Pathology Physician
- Hartford, CT
- NPI 1063464477
-
- Psychiatric Hospital Unit
- Norwich, CT
- NPI 1730243536
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
-
- General Acute Care Hospital
- Middletown, CT
- NPI 1760454334
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1639135718
-
- Psychiatric Hospital Unit
- Norwich, CT
- NPI 1730243536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1336535202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SILAS DEANE HWY",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094337",
"telephone_number": "860-972-9033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 FT WASHINGTN AVE # 7GS-313",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323733",
"telephone_number": "212-305-3038"
}
],
"practiceLocations": [
{
"address_1": "69 Jesse Hill Jr. Drive SE",
"address_2": "Glenn Memorial Building, 3rd Floor",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "30303",
"country_code": "US",
"telephone_number": "404-251-8915",
"fax_number": "404-523-3931",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "M.D., M.B.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-07",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A158522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.