Individual provider Active NPI

David Hyunsoo Kim, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1396705661
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9568 Issued in NV
Practice address
5380 S Rainbow Blvd
310
Las Vegas, NV 89118-1877
Phone
(702) 939-1600
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9568 NV Primary

Addresses

Primary practice location

5380 S Rainbow Blvd
310
Las Vegas, NV 89118-1877

Mailing address

5380 S Rainbow Blvd
310
Las Vegas, NV 89118
Phone (702) 939-1600

Other identifiers 1

IdentifierTypeStateIssuer
CC6606OtherNVBLU CROSS BLUE SHIELD

Other names 1

  • Hyun-Soo Kim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20070115000355 NV Practitioner - Internal Medicine 8729040209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5380 S Rainbow Blvd
Suite 310
Las Vegas, NV 89118-1880
Phone (702) 939-1600

Hospital & facility affiliations

  • Accelerated Home Health Care, LLC Home health agency, Las Vegas, NV, CCN 297223

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9568NVMDInternal Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAGAAA/Endpoint/HAGAAA

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 1

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396705661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD",
            "address_2": "310",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89118",
            "telephone_number": "702-939-1600",
            "fax_number": "702-932-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 S RAINBOW BLVD",
            "address_2": "310",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181877",
            "telephone_number": "702-939-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "HYUNSOO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "9568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLU CROSS BLUE SHIELD",
            "identifier": "CC6606",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HYUN-SOO",
            "last_name": "KIM",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.