Individual provider Active NPI

Michael Kim, MD

  • Diagnostic Radiology Physician
  • Round Rock, TX
National Provider Identifier
1578751400
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
P5397 Issued in TX
Practice address
300 University Blvd
Round Rock, TX 78665-1032
Phone
(512) 509-0100
Fax
(512) 218-6330
NPI assigned
Oct 4, 2007
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A104900 CA
Diagnostic Radiology Physician 2085R0202X P5397 TX Primary

Addresses

Primary practice location

300 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130801000392 TX Practitioner - Diagnostic Radiology 6608032180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
JS Weill Medical College, Cornell University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Outpatient Imaging Partnership LTDGroup PAC ID 5698729044, 13 clinicians

Practice addresses (Care Compare)

9110 Fairland St
San Antonio, TX 78230-4434
Phone (800) 475-3698

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Diagnostic Radiology CurrentSince Jun 13, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Mar 1, 2016 Accepting new patients
Diagnostic Outpatient Imaging Partnership LTD Diagnostic Radiology CurrentSince Sep 1, 2025 Accepting new patients
Btdi JV, LLP CurrentSince Mar 1, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Jun 15, 2016 Accepting new patients
Scott & White Clinic Diagnostic Radiology CurrentSince Jun 13, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Mar 1, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
1St Texas Home Health of San Angelo, Inc. Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

6065 Montana Ave
Ste A6
El Paso, TX 79925

300 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

Interoperability endpoints

  • Direct secure messaging: mkim207199@direct.sw.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1578751400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111",
            "fax_number": "254-724-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0100",
            "fax_number": "512-218-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A104900",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "P5397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.