Sang W Kim, MD

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

License

273922 Issued in NY

Practice address

4939 Brittonfield Pkwy
Building B, Suite 210
East Syracuse, NY 13057-9208

Phone

(315) 471-8404

Fax

(315) 471-6803

NPI assigned

Apr 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Harvard Medical School, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skim2387870@direct.trinity-health.org
• Direct secure messaging: skim@cnyfacialsurgery.medentdirect.com

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.

• Cayuga Ear, Nose, Throat-Head & Neck Surgery, PLLC

  • Otolaryngology Physician
  • Ithaca, NY
  • NPI 1356540603

  NY

  Medicare reassignment NPD
• Cny Facial Surgery Group, PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • E. Syracuse, NY
  • NPI 1831297183

  NY, Plastic Surgery Within the Head & Neck

  Medicare reassignment NPD
• Cortland ENT, PC

  • Sleep Medicine (Otolaryngology) Physician
  • Cortland, NY
  • NPI 1417144239

  NY

  Medicare reassignment NPD

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

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1548434236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "address_2": "BUILDING B, SUITE 210",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-471-8404",
            "fax_number": "315-471-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 BRITTONFIELD PKWY",
            "address_2": "BUILDING B, SUITE 210",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579208",
            "telephone_number": "315-471-8404",
            "fax_number": "315-471-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANG",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NY",
            "license": "273922",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "273922",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03855896",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Obrien Licensed Clinical Social Worker
• Lauren Kennedy, MS, CAS
• Melinda Kernan
• Christine Khanzadian
• Elizabeth M Kiggins, PT
• Leah Marion King, LMSW
• Matthew King
• Michelle Lynn King, LMSW
• Laura Lynn Kirkpatrick, MS PT
• Jeffrey J Kirshner, M.D.

• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in East Syracuse, NY
• Providers in East Syracuse, NY by specialty
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.