Individual provider Active NPI

Sang K Kim, M.D

  • Anesthesiology Physician
  • Toms River, NJ
National Provider Identifier
1487765509
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA03464100 Issued in NJ
Practice address
409 Main St FL 2
Toms River, NJ 08753-7441
Phone
(732) 818-7575
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA03464100 NJ Primary

Addresses

Primary practice location

409 Main St FL 2
Toms River, NJ 08753-7441

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050816000849 NJ Practitioner - Anesthesiology 9436189792 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03464100NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Anesthesia Associates LLC Anesthesiology CurrentSince Sep 28, 2022 Accepting new patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Nov 18, 2014 Accepting new patients
Toms River Perioperative Associates, LLC Anesthesiology Past Accepting new patients

Locations

1 N Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-7333

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1487765509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 MAIN ST FL 2",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087537441",
            "telephone_number": "732-818-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANG",
        "middle_name": "K",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA03464100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.