Jai Kim, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

52931 Issued in AZ

Practice address

4524 N Maryvale Pkwy Ste 220
Phoenix, AZ 85031

Phone

(238) 463-1866

Fax

(623) 846-3757

NPI assigned

Jun 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jai.kim.1@19654.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 and National Provider Directory roles.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group NPD
• Honorhealth Medical Group, LLC

  • Primary Care Clinic/Center
  • Peoria, AZ
  • NPI 1043851793
  Medicare reassignment NPD
• VHS Outpatient Clinics, Inc.

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964

  Family Medicine

  Medicare reassignment NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1285338343
  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1356965677
  NPD
• VHS Outpatient Clinics, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Scottsdale, AZ
  • NPI 1891302790
  NPD
• Pine Bush Mental Health, LLP

  • Clinical Psychologist
  • Albany, NY
  • NPI 1962572362
  NPD (past)
• Sunnyview Hospital and Rehabilitation Center

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1578664470
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1407892268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4524 N MARYVALE PKWY STE 220",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311732",
            "telephone_number": "623-846-3186",
            "fax_number": "623-846-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 N MARYVALE PKWY STE 220",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85031",
            "telephone_number": "238-463-1866",
            "fax_number": "623-846-3757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4524 N Maryvale Pkwy Ste 220",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850311732",
            "country_code": "US",
            "telephone_number": "238-463-1866",
            "fax_number": "623-846-3757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Empire Drive Suite 100",
            "address_2": "Capital Region Familiy Health Care",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "12144",
            "country_code": "US",
            "telephone_number": "518-286-4899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "233212",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "52931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02613789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Chan Kyum Kim, DO
• Dennis Kim, DMD
• Eugene M Kim
• Hyun Jae Kim, MD
• Hyun Jung Kim, PHARMD
• James W Kim, PT, DPT
• Janet Kim
• Janice Jinju Kim, DMD
• Jee Kim
• Juliane Kim, M.D.

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.