Individual provider Active NPI

Daniel Wonsuk Kim, M.D.

  • Surgical Oncology Physician
  • Rochester, NY
National Provider Identifier
1376078014
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
322386 Issued in NY
Practice address
125 Red Creek Dr Ste 211
Rochester, NY 14623-4262
Phone
(585) 487-1700
NPI assigned
May 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT219423 PA
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Oncology Physician 2086X0206X 322386 NY Primary

Addresses

Primary practice location

125 Red Creek Dr Ste 211
Rochester, NY 14623-4262

Mailing address

601 Elmwood Ave Box Surg
Rochester, NY 14642-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240906003642 NY Practitioner - Surgical Oncology 1759821531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breast Cancer Surgery of the University of RochesterGroup PAC ID 0446313621, 16 clinicians

Practice addresses (Care Compare)

125 Red Creek Dr
Suite 211
Rochester, NY 14623-4262
Phone (585) 487-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy50

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT219423PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breast Cancer Surgery of the University of Rochester Surgical Oncology CurrentSince Oct 1, 2024 Accepting new patients

Locations

111 Clara Barton St
Dansville, NY 14437
Phone (585) 335-3100

125 Red Creek Dr
Ste 211
Rochester, NY 14623
Phone (585) 486-0600

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: dkim499983@direct.urmc.rochester.edu

Organizations & group practices 1

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 4

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1376078014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX SURG",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 RED CREEK DR STE 211",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234262",
            "telephone_number": "585-487-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "WONSUK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT219423",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "322386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.