Individual provider Active NPI

Brian Yongjin Kim, MD

  • Obstetrics & Gynecology Physician
  • Rockville, MD
National Provider Identifier
1336776012
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0102603 Issued in MD
Practice address
9420 Key West Ave Ste 415
Rockville, MD 20850-6327
Phone
(301) 897-9817
NPI assigned
Mar 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X D0102603 MD Primary

Addresses

Primary practice location

9420 Key West Ave Ste 415
Rockville, MD 20850-6327

Mailing address

5801 Postal Rd Unit 81310
Cleveland, OH 44181-2112
Phone (301) 340-8339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250307002773 DC Practitioner - Obstetrics/Gynecology 5991128456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Womens Care LLCGroup PAC ID 4880582741, 281 clinicians

Practice addresses (Care Compare)

9420 Key W Ave
Suite 415
Rockville, MD 20850-3334
Phone (301) 279-9400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0102603MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women'S Care, L.L.C. Obstetrics & Gynecology CurrentSince Mar 6, 2025 Accepting new patients
Meritus Medical Center Inc Past Accepting new patients

Locations

9711 Medical Center Dr
Ste 109
Rockville, MD 20850
Phone (301) 762-5501

Interoperability endpoints

  • Direct secure messaging: brian.kim.d1.p1@direct.cwcare.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1336776012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 POSTAL RD UNIT 81310",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441812112",
            "telephone_number": "301-340-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 KEY WEST AVE STE 415",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506327",
            "telephone_number": "301-897-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BRIAN",
        "middle_name": "YONGJIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0102603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.