Katelyn Mariko Kim, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2022-02027 Issued in NC

Practice address

110 Preston Executive Dr Ste 100
Cary, NC 27513-8447

Phone

(919) 653-1344

NPI assigned

Mar 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Katelyn Mariko Updyke Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Dermatology

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Dermatology Center PAGroup PAC ID 8123006947, 31 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Promoting interoperability

89

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

92.77 of 100Reported as group

Quality

82.92

Promoting interoperability

100

Improvement activities

40

Cost

92.99

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katelyn.kim@qdp.emadirect.md
• Direct secure messaging: katelynk@centralderm.emadirect.md

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.

• Central Dermatology Center, PA

  • Dermatology Physician
  • Chapel Hill, NC
  • NPI 1568424299
  Medicare reassignment Care Compare group NPD
• Skin Surgery Center PA

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1649237082
  Medicare reassignment NPD
• Skin Surgery Center PA

  • MOHS-Micrographic Surgery Physician
  • Mount Pleasant, SC
  • NPI 1851810279
  NPD

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698537600000",
    "number": "1487159596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PRESTON EXECUTIVE DR STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138447",
            "telephone_number": "919-653-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PRESTON EXECUTIVE DR STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138447",
            "telephone_number": "919-653-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KATELYN",
        "middle_name": "MARIKO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2022-02027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "UPDYKE",
            "middle_name": "MARIKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jerrod Killillay
• Layla Marie Kilmer
• Piper Phin Kilpatrick, M.D.
• Kim a. Miller, DDS,PA
• Alexis Kim
• Kirstin Kim
• Sarah Yeon Kim, AGPCNP-BC
• Susan Kim, M.S., CCC-SLP
• Kimberly Lin, DDS, PLLC
• Kinard Center for Communication Development, LLC

• Dermatology Physician in Cary, NC
• Providers in Cary, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2023; 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.