Thomas Ouyjuung Kim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036143911 Issued in IL

Practice address

5359 W Fullerton Ave
Chicago, IL 60639-1450

Phone

(773) 836-2785

Fax

(773) 836-7381

NPI assigned

Jun 17, 2009

Last updated

Dec 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

Northwestern University Feinberg Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Esperanza Health CentersGroup PAC ID 2961453105, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4
• Direct secure messaging: kim.thomas.1@11903.direct.athenahealth.com

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.

• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1124187125
  Medicare reassignment Care Compare group NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1487124707
  NPD
• Esperanza Health Centers

  dba Lakeshore Hotel Shelter

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1659127199
  NPD
• PCC Community Wellness Center

  dba PCC Austin Dental & Specialty Care Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• Lynn Community Health, Inc.

  dba Lynn Community Health Pharmacy

  • Community/Retail Pharmacy
  • Lynn, MA
  • NPI 1477213031
  NPD
• Esperanza Health Centers

  dba Esperanza at Cultivate Collective

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1265114623
  NPD (past)

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1407083488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 526",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019030626",
            "telephone_number": "781-581-3900",
            "fax_number": "781-598-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391450",
            "telephone_number": "773-836-2785",
            "fax_number": "773-836-7381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Union St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019011314",
            "country_code": "US",
            "telephone_number": "781-581-3900",
            "fax_number": "781-598-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "THOMAS",
        "middle_name": "OUYJUUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "241080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036143911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tae Min Kim
• Tae Woo Kim, MD
• Teresa S. Kim, M.D.
• Theresa Kim
• Thomas Kim, M.D.
• Tiffany Kim, OTR/L
• Tong Su Kim, MD
• Ung Kwang Kim, DDS
• Vanessa Yon Kim, M.D.
• William L Kim, DO

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; 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.

Verify at the official NPI Registry.