NPIMap

Individual provider Active NPI

Peter Eugene Kim, MD

  • Diagnostic Radiology Physician
  • Albany, NY
National Provider Identifier
1336593391
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A158981 Issued in CA
Practice address
47 New Scotland Ave
Albany, NY 12208-3412
Phone
(518) 262-3277
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A158981 CA Primary

Addresses

Primary practice location

47 New Scotland Ave
Albany, NY 12208-3412

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 783-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY, IL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210625002268 CA Practitioner - Diagnostic Radiology 9638570781 Reassigns benefits to 4 organizations
I20220811000717 NY Practitioner - Diagnostic Radiology 9638570781 Reassigns benefits to 6 organizations
I20260501000678 IL Practitioner - Diagnostic Radiology 9638570781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians
Albany Medical Center HospitalGroup PAC ID 8224018999, 45 clinicians

Practice addresses (Care Compare)

1116 Huntington Dr
Apt 112
Mundelein, IL 60060-4904
Phone (518) 262-3277

159 Jefferson HTS
Catskill, NY 12414-1237
Phone (518) 828-7601

25 Hackett Blvd
Albany, NY 12208-3462
Phone (518) 262-1244

2693 W Lincoln Ave
Unit 2
Anaheim, CA 92801-8256
Phone (518) 262-3277

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

2963 W Lincoln Ave
Unit 2
Anaheim, CA 92801-8256
Phone (518) 262-3277

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5149

711 Troy Schenectady Rd
Suite 114
Latham, NY 12110-2454
Phone (518) 786-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158981CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical Center Hospital Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Community Care Physicians, PLLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Ellis Hospital CurrentSince Aug 9, 2022 Accepting new patients
Columbia Memorial Hospital CurrentSince Aug 1, 2022 Accepting new patients
Columbia Memorial Hospital CurrentSince Aug 1, 2022 Accepting new patients
Regents of the Univ of Ca Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Albany Medical College Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Albany Medical College CurrentSince Aug 1, 2022 Accepting new patients
Albany Medical College CurrentSince Aug 1, 2022 Accepting new patients
New York Oncology Hematology, P.C. CurrentSince Mar 1, 2025 Accepting new patients
New York Oncology Hematology PC CurrentSince Mar 1, 2025 Accepting new patients

Locations

2693 W Lincoln Ave
Unit 2
Anaheim, CA 92801

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4860 Y St
Ste 3100
Sacramento, CA 95817
Phone (916) 703-2273

43 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5149

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1367 Washington Ave
Albany, NY 12206
Phone (518) 438-7926

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

69 Prospect Ave
Hudson, NY 12534
Phone (212) 459-8173

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 114
Latham, NY 12110
Phone (518) 783-7070

896 Riverview Rd
Rexford, NY 12148
Phone (518) 399-4600

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

2827 US Highway 9
Valatie, NY 12184
Phone (518) 828-7601

Interoperability endpoints

  • Direct secure messaging: pkim33857@albanymed.direct-ci.com

Organizations & group practices 12

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 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1336593391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-783-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A158981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.