Eun Jong Kim, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

51157 Issued in MN

Practice address

404 W Fountain St
Albert Lea, MN 56007-2437

Phone

(507) 373-2384

NPI assigned

May 22, 2008

Last updated

Sep 28, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Physical Medicine and Rehabilitation

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Southeast Minnesota RegionGroup PAC ID 4385556703, 550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System - Albert Lea and Austin Hospital, Albert Lea, MN, CCN 240043
• Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010
• Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mayo Clinic Health System-Southeast Minnesota Region

  dba Mayo Clinic Health System-Albert Lea and Austin

  • Multi-Specialty Clinic/Center
  • Albert Lea, MN
  • NPI 1891701637
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southeast Minnesota Region

  dba Mayo Clinic Health System Pharmacy - Cannon Falls

  • Clinic Pharmacy
  • Cannon Falls, MN
  • NPI 1699597468
  NPD

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

• Mayo Clinic Health System-Southeast Minnesota Region

  dba Mayo Clinic Health System-Albert Lea and Austin

  • General Acute Care Hospital
  • Albert Lea, MN
  • NPI 1346258100
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487
  Care Compare affiliation
• Mayo Clinic Hospital-Rochester

  • General Acute Care Hospital
  • Rochester, MN
  • NPI 1841266194
  Care Compare affiliation

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1487811782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUN JONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "103699",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "51157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekim89191@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "404 W Fountain St",
            "city": "Albert Lea",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560072437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie Johannsen, PT
• John M Enger, Professional Association (Community Foot Clinic)
• Donald J.F. Kammerer, M.D.
• Mariah Kelly, APRN, CRNA
• Debra Khan
• Amanda Kingery, PHARMD
• Travis Klatt
• Cathy Schmidt Klick, RN CNP
• Jennie Kay Knudtson, CNP
• Nancy Ann Knudtson, ARNP

• Physical Medicine & Rehabilitation Physician in Albert Lea, MN
• Providers in Albert Lea, MN by specialty
• Physical Medicine & Rehabilitation Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.