Active NPI
Stanley Kim, MD
- Vascular & Interventional Radiology Physician
- Winfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- 036109828
- Practice address
- 25 N Winfield Rd
Winfield, IL 60190-1295 - Phone
- (630) 933-2489
- Fax
- (630) 933-2827
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A71763 | CA | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 036109828 | IL | Primary |
Addresses
Primary practice location
25 N Winfield Rd
Winfield, IL 60190-1295
Mailing address
25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 933-2489
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A717630 | Other | CA | MEDI CAL |
| 036109828 | Medicaid | IL | |
| 0222075 | Other | IL | BLUE CROSS GROUP NUMBER |
| 3631498336019001 | Other | IL | CDPG HFS PAYEE ID |
| 3625139096019701 | Other | IL | CDH HFS GROUP PAYEE ID |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800
25 N Winfield Rd
Winfield, IL 60190-1295
25 N Winfield Rd
Winfield, IL 60190-1379
Phone (630) 933-4480
Hospital & facility affiliations
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine Delnor Community Hospital
- Macneal Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A71763 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Hospital Association | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients | |
| Winfield Pathology Consultants, S.C. | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Diagnostic Radiology | Current | Accepting new patients |
| Central Dupage Physician Group | Vascular & Interventional Radiology | Current | Accepting new patients |
| Central Dupage Hospital Association | Current | Accepting new patients | |
| UCLA Radiology Medical Group | Diagnostic Radiology | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
25 N Winfield Rd
Ste 201
Winfield, IL 60190
Phone (630) 933-4480
25 N Winfield Rd
Ste 401
Winfield, IL 60190
Phone (630) 933-4200
25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600
Organizations & group practices 8
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
Vascular & Interventional Radiology
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
Diagnostic Radiology
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
- Anatomic Pathology Physician
- Winfield, IL
- NPI 1528147071
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1881670248
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- General Acute Care Hospital
- Geneva, IL
- NPI 1407859655
-
- General Acute Care Hospital
- Berwyn, IL
- NPI 1295710580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1437188018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 N WINFIELD RD",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601901295",
"telephone_number": "630-933-2489",
"fax_number": "630-933-2827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N WINFIELD RD",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601901295",
"telephone_number": "630-933-2489",
"fax_number": "630-933-2827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "STANLEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A71763",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "IL",
"license": "036109828",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI CAL",
"identifier": "00A717630",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036109828",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS GROUP NUMBER",
"identifier": "0222075",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPG HFS PAYEE ID",
"identifier": "3631498336019001",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDH HFS GROUP PAYEE ID",
"identifier": "3625139096019701",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.