Jae Yong Kim, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301507485 Issued in MI

Practice address

1922 Monroe St
Dearborn, MI 48124-2917

Phone

(313) 274-7540

NPI assigned

Mar 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Ophthalmology

Education

Univ of Central Florida, College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harper University Hospital Hospital, Detroit, MI, CCN 230104

Merit-based Incentive Payment System (MIPS)

Final score

75.03 of 100Reported as group

Quality

85.46

Promoting interoperability

100

Improvement activities

40

Cost

31.32

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jae.kim.p1@direct.grophthalmology.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/DJIFDD/Endpoint/DJIFDD
• Direct secure messaging: jae.kim.1@11987.direct.athenahealth.com
• Direct secure messaging: jae.kim.1@19711.direct.athenahealth.com

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.

• Eyecue Solutions PLLC

  • Ophthalmology Physician
  • Sterling Heights, MI
  • NPI 1942058904
  Medicare reassignment NPD Authorized official
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• Blue Sky Vision Eye Care, P.C

  • Ophthalmology Physician
  • Grand Rapids, MI
  • NPI 1801977202
  Medicare reassignment NPD
• Blue Sky Vision Eye Care, PC

  • Ophthalmology Physician
  • Dearborn, MI
  • NPI 1316675598
  NPD
• University Physician Group

  • Social Worker
  • Livonia, MI
  • NPI 1154360402
  NPD (past)
• Walker Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Walker, MI
  • NPI 1679612253
  NPD (past)

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

• VHS Harper-Hutzel Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1497287635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242917",
            "telephone_number": "313-274-7540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Stein Plz",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900957408",
            "country_code": "US",
            "telephone_number": "310-825-3090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4717 Saint Antoine St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482011423",
            "country_code": "US",
            "telephone_number": "313-577-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6850 Lake Nona Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328277408",
            "country_code": "US",
            "telephone_number": "407-518-2751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAE",
        "middle_name": "YONG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A171816",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301507485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Degenstein Kiernan, CRNA
• Tabitha Kildani, PA
• Madison Killion
• Dong H Kim, M.D.
• Hi Joo Kim, MD
• Joon K Kim, M.D.
• Kihyun Kim, D.D.S., M.S.
• Lydia Kim, MD
• Cortney Kimbrough
• Kertina Lynese Kimbrough, LPC

• Ophthalmology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.