NPIMap

Individual provider Active NPI

Mark M Kim, MD

  • Internal Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1578597282
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0054574 Issued in MD
Practice address
7927 Ritchie Hwy.
Glen Burnie, MD 21061
Phone
(410) 761-2273
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0054574 MD Primary

Addresses

Primary practice location

7927 Ritchie Hwy.
Glen Burnie, MD 21061

Mailing address

301 St. Paul Place
Medical Staff Office
Baltimore, MD 21202-2102

Other practice location 1

1412 Crain Highway
Suite 6A
Glen Burnie, MD 21061
Phone (410) 761-1744

Other identifiers 4

IdentifierTypeStateIssuer
2197875OtherMDAETNA
S190 / 0009OtherMDBLUE CHOICE
KF68 / 607687-01, 02OtherMDBC/BS OF MD
730901500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20101101000527 MD Practitioner - Internal Medicine 0143414441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as individual
Quality
56.91
Promoting interoperability
100
Improvement activities
40
Cost
95

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Family Care, Inc. Internal Medicine CurrentSince Mar 1, 2000 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7927 Ritchie Hwy
Glen Burnie, MD 21061
Phone (410) 494-9099

1412 Crain Hwy N
Ste 6A
Glen Burnie, MD 21061
Phone (410) 761-1744

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: mkim22311@direct.umm.edu
  • Direct secure messaging: mkimmd6491@direct.mdmercy.com

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1578597282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7927 RITCHIE HWY.",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-761-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1412 Crain Highway",
            "address_2": "Suite 6A",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "21061",
            "country_code": "US",
            "telephone_number": "410-761-1744",
            "fax_number": "410-761-4353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0054574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2197875",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "S190 / 0009",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MD",
            "identifier": "KF68 / 607687-01, 02",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730901500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.