Individual provider Active NPI

Tricia Kim, DO

  • Surgery Physician
  • Toledo, OH
National Provider Identifier
1417444308
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
34.017359 Issued in OH
Practice address
4235 Secor Rd
Toledo, OH 43623-4299
Phone
(419) 473-3561
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 34.017359 OH Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4299

Mailing address

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561

Other practice location 1

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-7614

Other practice location 2

2213 Cherry Street
ACC, 1st Floor
Toledo, OH 43608
Phone (419) 251-6596

Other practice location 3

1200 Medical Center Pkwy
Maumee, OH 43537-1921
Phone (419) 479-5713

Other identifiers 1

IdentifierTypeStateIssuer
0096998MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240617002518 OH Practitioner - General Surgery 9830632082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 479-5398

7640 Sylvania Ave
Suite a 1
Sylvania, OH 43560-9263
Phone (419) 251-4790

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.017359OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Oct 7, 2024 Accepting new patients
Toledo Clinic Incorporated Surgery Current Accepting new patients
Mercy Health Physicians North Specialty Care LLC Surgery CurrentSince Oct 7, 2024 Accepting new patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated CurrentSince Jun 6, 2024 Accepting new patients
Toledo Clinic Incorporated CurrentSince Jun 6, 2024 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients
Mercy Health Physicians-North LLC Past Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

1200 Medical Center Pkwy
Maumee, OH 43537
Phone (419) 794-7720

7640 Sylvania Ave
Ste A-1
Sylvania, OH 43560
Phone (419) 251-4790

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2213 Cherry St
Fl 1
Toledo, OH 43608
Phone (419) 251-4724

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

3404 W Sylvania Ave
Toledo, OH 43623
Phone (419) 407-1422

Interoperability endpoints

  • Direct secure messaging: tkim345862@direct.bsmhealth.org

Organizations & group practices 9

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 3

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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1417444308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Woods Rd",
            "address_purpose": "LOCATION",
            "city": "Valhalla",
            "state": "NY",
            "postal_code": "105951530",
            "country_code": "US",
            "telephone_number": "914-493-7614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Cherry Street",
            "address_2": "ACC, 1st Floor",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43608",
            "country_code": "US",
            "telephone_number": "419-251-6596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435371921",
            "country_code": "US",
            "telephone_number": "419-479-5713",
            "fax_number": "419-479-5714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "TRICIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34.017359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096998",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.