Active NPI
Thomas Kim
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1346653664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 260087
- Practice address
- 800 Washington St.
#1007
Boston, MA 02111 - Phone
- (617) 636-7802
- NPI assigned
- Jun 4, 2014
- Last updated
- Jun 4, 2014
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 260087 | MA | Primary |
Addresses
Primary practice location
800 Washington St.
#1007
Boston, MA 02111
Mailing address
4928 Jacks Creek Rd
Monroe, GA 30655
Phone (770) 207-4311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2225 Challenger Way
Santa Rosa, CA 95407-5441
Phone (707) 565-4861
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Sonoma | Current | Accepting new patients | |
| County of Sonoma | Current | Accepting new patients |
Locations
1450 Neotomas Ave
Ste 200
Santa Rosa, CA 95405
Phone (707) 490-2102
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community Health Clinic/Center
- Cloverdale, CA
- NPI 1952637027
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Santa Rosa, CA
- NPI 1952515462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1346653664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4928 JACKS CREEK RD",
"city": "MONROE",
"state": "GA",
"postal_code": "30655",
"telephone_number": "770-207-4311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST.",
"address_2": "#1007",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "617-636-7802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-04",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "260087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.