NPIMap

Individual provider Active NPI

Michael D Kim, D.O.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Scranton, PA
National Provider Identifier
1427002179
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
OS012236 Issued in PA
Practice address
475 Morgan Hwy
Scranton, PA 18508-2605
Phone
(570) 348-1118
Fax
(570) 348-1109
NPI assigned
May 19, 2006
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X OS012236 PA Primary

Addresses

Primary practice location

475 Morgan Hwy
Scranton, PA 18508-2605

Mailing address

475 Morgan Hwy
Scranton, PA 18508-2605
Phone (570) 348-1118

Other practice location 1

5 Morgan Hwy Ste 4
Scranton, PA 18508-2641
Phone (570) 344-3788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060719000003 PA Practitioner - Neurology 1759393051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

475 Morgan Hwy
Scranton, PA 18508-2605
Phone (570) 348-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS012236PAMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Rehabilitation Associates, PC CurrentSince May 17, 2021 Accepting new patients

Locations

475 Morgan Hwy
Ste 4
Scranton, PA 18508

475 Morgan Hwy
Scranton, PA 18508
Phone (570) 344-3788

802 Jefferson Ave
Ste 301
Scranton, PA 18510
Phone (570) 348-1118

5 Morgan Hwy
Ste 4
Scranton, PA 18508
Phone (570) 344-3788

Interoperability endpoints

  • Direct secure messaging: mkim@nerehab.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1427002179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 MORGAN HWY",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082605",
            "telephone_number": "570-348-1118",
            "fax_number": "570-348-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 MORGAN HWY",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082605",
            "telephone_number": "570-348-1118",
            "fax_number": "570-348-1109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Morgan Hwy Ste 4",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185082641",
            "country_code": "US",
            "telephone_number": "570-344-3788",
            "fax_number": "570-969-9280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "PA",
            "license": "OS012236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.