NPIMap

Individual provider Active NPI

Kenneth Lim, D.O.

  • Urology Physician
  • Waterford, MI
National Provider Identifier
1548339898
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
KL007576 Issued in MI
Practice address
3145 Dixie Hwy
Waterford, MI 48328-1602
Phone
(248) 674-8530
Fax
(248) 674-2198
NPI assigned
Nov 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X KL007576 MI Primary

Addresses

Primary practice location

3145 Dixie Hwy
Waterford, MI 48328-1602

Mailing address

3145 Dixie Hwy
Waterford, MI 48328-1602
Phone (248) 674-8530

Other identifiers 1

IdentifierTypeStateIssuer
1506795MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100305000457 MI Practitioner - Urology 7012967425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Michigan State University College of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

3145 Dixie Hwy
Waterford, MI 48328-1602
Phone (248) 674-8530

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KL007576MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
Oakland County Urologists PC Urology Current Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
Kensington Valley Heart, PC PastSince Apr 12, 2021 Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1435 N Milford Rd
Ste 201
Milford, MI 48381
Phone (248) 305-8707

39475 Lewis Dr
Ste 280
Novi, MI 48377
Phone (248) 876-8211

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

31157 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-2250

3145 Dixie Hwy
Waterford, MI 48328
Phone (248) 674-8530

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGFBBD
  • Direct secure messaging: klim@direct.dmc.org
  • Direct secure messaging: klim1139253@direct.hfhs.org

Organizations & group practices 4

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548339898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281602",
            "telephone_number": "248-674-8530",
            "fax_number": "248-674-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281602",
            "telephone_number": "248-674-8530",
            "fax_number": "248-674-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "KL007576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506795",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.