Nicholas Kim, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP9542 Issued in AZ

Practice address

3104 E Indian School Rd Ste 100
Phoenix, AZ 85016-6873

Phone

(602) 266-0266

Fax

(602) 266-9757

NPI assigned

Sep 29, 2016

Last updated

Sep 2, 2020By 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 AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Dermatology PLLCGroup PAC ID 1557355385, 69 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.48 of 100Reported as group

Quality

82.26

Promoting interoperability

83

Improvement activities

40

Cost

76.85

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Center for Dermatology, PLLC

  dba Arizona Dermatology

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1194792416
  Medicare reassignment Care Compare group NPD
• English Dermatology PC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1245659432
  Medicare reassignment NPD
• Center for Dermatology, PLLC

  • Medical Physician Assistant
  • Scottsdale, AZ
  • NPI 1174062673
  NPD (past)
• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609291848
  NPD (past)

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1427507680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 E INDIAN SCHOOL RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166873",
            "telephone_number": "602-266-0266",
            "fax_number": "602-266-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "NICHOLAS",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN180149",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliane Kim, M.D.
• Kiup Alexander Kim, MD, RPVI
• Max Chung Ho Kim, MD
• Michelle Sang Yun Kim, MD
• Min Kyong Michelle Kim, DO
• Olivia Kim
• Paul K. Kim, MD
• Samuel Kim
• Sarah Kim, PHARM.D.
• Sean W Kim, D.O

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.