Individual provider Active NPI

Alvin Kim, M.D.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1497117121
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA11048300 Issued in NJ
Practice address
622 W 168TH St
PH5-133 Stem
New York, NY 10032-3720
Phone
(212) 342-5525
Fax
(212) 305-3204
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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 25MA11048300 NJ Primary

Addresses

Primary practice location

622 W 168TH St
PH5-133 Stem
New York, NY 10032-3720

Mailing address

2301 E St NW
Apt A613
Washington, DC 20037-2829
Phone (323) 533-3398

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
I20210927000630 NJ Practitioner - Anesthesiology 6709122419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
George Washington University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutgers Health-RWJ Pediatric Critical CareGroup PAC ID 1355390287, 153 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11048300NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Aug 1, 2021 Accepting new patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Aug 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Aug 1, 2021 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care Anesthesiology CurrentSince Aug 1, 2021 Accepting new patients

Locations

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

Organizations & group practices 7

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 1

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1497117121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E ST NW",
            "address_2": "APT A613",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372829",
            "telephone_number": "323-533-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "PH5-133 STEM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-342-5525",
            "fax_number": "212-305-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-04-30",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA11048300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.