Individual provider Active NPI

Sun Kim, M.D.

  • Vascular Surgery Physician
  • Detroit, MI
National Provider Identifier
1457766958
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301506817 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8875
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301506817 MI Primary
Surgery Physician 208600000X 4301105689 MI

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

4354 Ramsgate LN
Bloomfield Hills, MI 48302-1638
Phone (517) 303-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220812000302 MI Practitioner - Vascular Surgery 9739494311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040

Hospital & facility affiliations

  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105689MIMDSurgery Physician
4301506817MIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Jul 1, 2022 Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

311 Mack Ave
Ste 64100
Detroit, MI 48201
Phone (313) 832-0303

6001 W Outer Dr
Ste 321
Detroit, MI 48235
Phone (313) 341-5100

311 Mack Ave
Ste 63100
Detroit, MI 48201
Phone (313) 536-1525

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

Interoperability endpoints

  • Direct secure messaging: sun.kim.1@9704.direct.athenahealth.com
  • Direct secure messaging: skim861041@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1457766958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4354 RAMSGATE LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021638",
            "telephone_number": "517-303-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2022-09-08",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301506817",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301105689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.