Individual provider Active NPI

Nayoung Kim, M.D.

  • Allergy & Immunology Physician
  • Bethesda, MD
National Provider Identifier
1437359650
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
D0062723 Issued in MD
Practice address
10 Center Dr
BLG 10 Rm11N236
Bethesda, MD 20892-0001
Phone
(301) 594-5504
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X D0062723 MD Primary

Addresses

Primary practice location

10 Center Dr
BLG 10 Rm11N236
Bethesda, MD 20892-0001

Mailing address

11710 Old Georgetown Rd Apt 1519
Rockville, MD 20852-8601
Phone (301) 594-5504

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081112000430 CA Practitioner - Allergy/Immunology 2062571581 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062723MDMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Oct 20, 2010 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 20, 2010 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

10725 International Dr
Rncho Cordova, CA 95670
Phone (916) 631-2060

2345 Fair Oaks Blvd
Sacramento, CA 95825
Phone (916) 480-6715

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1437359650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 OLD GEORGETOWN RD APT 1519",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208528601",
            "telephone_number": "301-594-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CENTER DR",
            "address_2": "BLG 10 RM11N236",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-594-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "NAYOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MD",
            "license": "D0062723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10725 International Dr",
            "city": "Rancho Cordova",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956707967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.