Individual provider Active NPI

Amy E Kim, MD

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1457312019
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
048252 Issued in GA
Practice address
875 Johnson Ferry Rd NE
Suite 300
Atlanta, GA 30342-1418
Phone
(404) 257-9933
Fax
(404) 257-9931
NPI assigned
Mar 31, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 048252 GA Primary

Addresses

Primary practice location

875 Johnson Ferry Rd NE
Suite 300
Atlanta, GA 30342-1418

Mailing address

875 Johnson Ferry Rd NE
Suite 300
Atlanta, GA 30342-1418
Phone (404) 257-9933

Other identifiers 1

IdentifierTypeStateIssuer
048252OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050927000109 GA Practitioner - Dermatology 3779517917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Boston University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metroderm, P.C.Group PAC ID 8729076443, 33 clinicians

Practice addresses (Care Compare)

148 Bill Carruth Pkwy
Suite 280
Hiram, GA 30141-3756
Phone (404) 257-9933

4374 Atlanta Hwy
Suite 103
Hiram, GA 30141-1849
Phone (770) 726-1277

875 Johnson Ferry Rd
Atlanta, GA 30342-1418

875 Johnson Ferry Rd NE
Suite 001
Atlanta, GA 30342-1418
Phone (404) 257-9933

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision51
Removal of skin lesions333
Removal of skin cancer885
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metroderm, P.C. Mohs-Micrographic Surgery CurrentSince Sep 1, 2005 Accepting new patients
Metroderm, P.C. CurrentSince Sep 1, 2005 Accepting new patients

Locations

875 Johnson Fy Rd NE
Ste 300
Sandy Springs, GA 30342
Phone (404) 257-9933

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1457312019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 JOHNSON FERRY RD NE",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421418",
            "telephone_number": "404-257-9933",
            "fax_number": "404-257-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 JOHNSON FERRY RD NE",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421418",
            "telephone_number": "404-257-9933",
            "fax_number": "404-257-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "GA",
            "license": "048252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "048252",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.