Michelle Kim, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV009823-01 Issued in NY

Practice address

180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660

Phone

(215) 554-6222

Fax

(215) 554-6200

NPI assigned

Jul 5, 2023

Last updated

Jul 1, 2024By 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

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Line Eye Care LLCGroup PAC ID 2961893912, 4 clinicians

Harbison Eye Care LLCGroup PAC ID 7810223500, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• City Line Eye Care LLC

  dba City Ave Eye Care

  • Optometrist
  • Bala Cynwyd, PA
  • NPI 1851975312
  Medicare reassignment Care Compare group NPD
• Harbison Eye Care LLC

  • Optometrist
  • Philadelphia, PA
  • NPI 1174182588
  Medicare reassignment Care Compare group NPD
• New World Vision Center, Inc.

  • Optometrist
  • Philadelphia, PA
  • NPI 1427124221
  Medicare reassignment NPD
• Trend Eye Care II LLC

  • Optometrist
  • Philadelphia, PA
  • NPI 1285029223
  Medicare reassignment NPD
• Trend Eye Care LLC

  • Optometrist
  • Philadelphia, PA
  • NPI 1457780595
  Medicare reassignment NPD

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1497432058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5597 TULIP ST STE B8",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191241562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660",
            "telephone_number": "215-554-6222",
            "fax_number": "215-554-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Broad St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191223319",
            "country_code": "US",
            "telephone_number": "215-866-1742",
            "fax_number": "215-866-1759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "49 E City Ave # 10",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190042421",
            "country_code": "US",
            "telephone_number": "610-206-3866",
            "fax_number": "610-206-3836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5597 Tulip St Ste B8",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191241562",
            "country_code": "US",
            "telephone_number": "267-360-6944",
            "fax_number": "267-360-6945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Washington Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191474836",
            "country_code": "US",
            "telephone_number": "215-599-2020",
            "fax_number": "215-599-2023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004137",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009823-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndon Kim, M.D.
• Marc Jason Kim, M.D.
• Mark Sejun Kim, M.D.
• Meridith C Kim, PSY.D.
• Mi Hae Kim, PSY.D.
• Michelle Kim
• Michelle M Kim, PH.D.
• Mimi Sarah Kim, MD
• Mina Kim, PA-C
• Minje Kim, DMD

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.