Active NPI
Jason Kim, M.D.
- Pediatric Infectious Diseases Physician
- Philadelphia, PA
National Provider Identifier
1386667319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- MD419002
- Practice address
- 3401 Civic Center Blvd
Children'S Hospital of Phila - Infectious Diseases
Philadelphia, PA 19104-4319 - Phone
- (215) 590-2017
- Fax
- (215) 590-2025
- NPI assigned
- Jul 25, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD419002 | PA | |
| Pediatric Infectious Diseases Physician | 2080P0208X | MD419002 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Children'S Hospital of Phila - Infectious Diseases
Philadelphia, PA 19104-4319
Mailing address
100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9234
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0047287 | Medicaid | NJ | |
| 101118367 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
| Radiology Associates of Children'S Hospital, Inc | Past | Accepting new patients |
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.
-
- Pediatric Radiology Physician
- Philadelphia, PA
- NPI 1467403261
-
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1386667319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E PENN SQ",
"address_2": "9TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073323",
"telephone_number": "267-425-9234",
"fax_number": "267-425-9299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "CHILDREN'S HOSPITAL OF PHILA - INFECTIOUS DISEASES",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-2017",
"fax_number": "215-590-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JASON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD419002",
"primary": false
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "PA",
"license": "MD419002",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0047287",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101118367",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.