Mark Sejun Kim, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD448180 Issued in PA

Practice address

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824

Phone

(215) 955-6161

NPI assigned

Apr 1, 2009

Last updated

Nov 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Methodist Associates in Healthcare of New Jersey, P.C.Group PAC ID 4981965324, 136 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Methodist Associates in Healthcare of New Jersey, P.C.

  dba Jefferson Community Physicians of New Jersey

  • Cardiovascular Disease Physician
  • Robbinsville, NJ
  • NPI 1649636754

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Methodist Associates in Healthcare of New Jersey, P.C.

  dba Jefferson Community Physicians - Neurosurgery

  • Neurological Surgery Physician
  • Sewell, NJ
  • NPI 1568078095
  NPD

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

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1548402894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARK",
        "middle_name": "SEJUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD448180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102848574",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0365378",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Xiaoyan Kim, PHARMD
• Lauren Hayan Kim
• Lucy Kim, DMD
• Lyndon Kim, M.D.
• Marc Jason Kim, M.D.
• Meridith C Kim, PSY.D.
• Mi Hae Kim, PSY.D.
• Michelle Kim, OD
• Michelle Kim
• Michelle M Kim, PH.D.

• Anesthesiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Anesthesiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.