Bernard C. Kim, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

L8767 Issued in TX

Practice address

3636 Executive Center Dr Ste G70
Suite 212
Austin, TX 78731-1628

Phone

(512) 371-9555

Fax

(512) 367-5756

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pondworks PA

  • Psychiatry Physician
  • Austin, TX
  • NPI 1124139506
  NPD (past) Authorized official
• Frank S. Floca

  • Geriatric Psychiatry Physician
  • Austin, TX
  • NPI 1184665648
  NPD (past)
• West Texas Centers for MHMR

  • Psychiatry Physician
  • Big Spring, TX
  • NPI 1154348514
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1528074952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 EXECUTIVE CENTER DR STE G70",
            "address_2": "SUITE 212",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311628",
            "telephone_number": "512-371-9555",
            "fax_number": "512-367-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 EXECUTIVE CENTER DR STE G70",
            "address_2": "SUITE 212",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311628",
            "telephone_number": "512-371-9555",
            "fax_number": "512-367-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BERNARD",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L8767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER ID",
            "identifier": "517620",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Libby Counseling PLLC
• Kim Praderas PLLC
• Kim Tran, MD PA
• Soo Hee Kim-Delio, MD
• Ah Young Kim
• Dalwinn Dale Kim, APRN, PMHNP-BC
• David Donghyun Kim, MD
• Deborah Joo-Hee Kim, MD
• Dohyun Brandon Kim, PHARMD
• Gene Kim, M.D.

• Psychiatry Physician in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.