Individual provider Active NPI

Joon Paul Young Kim, M.D.,

  • Anesthesiology Physician
  • Las Vegas, NV
National Provider Identifier
1578503330
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
11755 Issued in NV
Practice address
9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253
Phone
(702) 878-0070
Fax
(702) 209-2064
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 11755 NV Primary

Addresses

Primary practice location

9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253

Mailing address

9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253
Phone (702) 878-0070

Other identifiers 1

IdentifierTypeStateIssuer
100510706MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20061212000329 NV Practitioner - Anesthesiology 2860419009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.25 of 100Reported as group
Quality
74.41
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11755NVMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fielden Hanson Isaacs Miyada Robison Yeh LTD Anesthesiology CurrentSince Sep 15, 2006 Accepting new patients
Arizona Anesthesia Consultants, Inc. Anesthesiology CurrentSince Feb 2, 2020 Accepting new patients
Summit Anesthesia Consultants, Inc Anesthesiology Past Accepting new patients

Locations

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

9127 W Russell Rd
Ste 110
Las Vegas, NV 89148
Phone (702) 209-2042

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1578503330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9127 W RUSSELL RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481253",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9127 W RUSSELL RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481253",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOON",
        "middle_name": "PAUL YOUNG",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "11755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510706",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.