Individual provider Active NPI

David D Kim, M.D.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Savannah, GA
National Provider Identifier
1508805052
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
047336 Issued in GA
Practice address
4849 Paulsen St Ste 312
Savannah, GA 31405-4426
Phone
(912) 483-8817
NPI assigned
Jun 6, 2006
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 047336 GA Primary
Ophthalmology Physician 207W00000X 047336 GA

Addresses

Primary practice location

4849 Paulsen St Ste 312
Savannah, GA 31405-4426

Mailing address

4849 Paulsen St Ste 312
Savannah, GA 31405-4426
Phone (912) 483-8817

Other practice location 1

16741 Ga-67
Suite F
Statesboro, GA 30458
Phone (912) 483-8817

Other identifiers 7

IdentifierTypeStateIssuer
000792932HOtherGAMEDICAID- VIDALIA
00792932BMedicaidGA
000792932FOtherGAMEDICAID - STATESBORO
1508805052OtherGAMEDICARE RAILROAD
782177OtherBLUE CROSS BLUE SHIELD
GPA977OtherSCMEDICAID GRP. SAV
00792932GOtherGAMEDICAID - SAVANNAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20081215000761 GA Practitioner - Ophthalmology 7719048339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Consultants of Savannah LLCGroup PAC ID 2365881117, 4 clinicians

Practice addresses (Care Compare)

4849 Paulsen St
Suite 312
Savannah, GA 31405-4426
Phone (912) 483-8817

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
047336GAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Consultants of Savannah LLC Ophthalmology CurrentSince Jun 1, 2024 Accepting new patients

Locations

4849 Paulsen St
Ste 312
Savannah, GA 31405
Phone (413) 218-1201

16741 Highway 67
Ste F
Statesboro, GA 30458
Phone (912) 681-4555

Organizations & group practices 1

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.

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1508805052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 PAULSEN ST STE 312",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054426",
            "telephone_number": "912-483-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 PAULSEN ST STE 312",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054426",
            "telephone_number": "912-483-8817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16741 GA-67",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "30458",
            "country_code": "US",
            "telephone_number": "912-483-8817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "GA",
            "license": "047336",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "047336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- VIDALIA",
            "identifier": "000792932H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00792932B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - STATESBORO",
            "identifier": "000792932F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "1508805052",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "782177",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GRP. SAV",
            "identifier": "GPA977",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - SAVANNAH",
            "identifier": "00792932G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.