Carl In Kim, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

R6030 Issued in TX

Practice address

300 University Blvd BLDG a
Round Rock, TX 78665-1032

Phone

(512) 509-0200

NPI assigned

Jun 14, 2007

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 2

Medicare fee-for-service enrollment

Enrolled in CA, TX2 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

Interventional RadiologyAlso: Diagnostic Radiology

Education

Wayne State University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
• Baylor Scott & White Medical Center - Marble Falls Hospital, Marble Falls, TX, CCN 670108
• Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128
• Baylor Scott & White Medical Center - Buda Hospital, Buda, TX, CCN 670131
• Baylor Scott & White Medical Center- Austin Hospital, Austin, TX, CCN 670136

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17475/brand/1/csg/1/fhir/r4
• Direct secure messaging: ckim325490@direct.sw.org

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.

• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• West Bay Nephrology Associates

  • Nephrology Physician
  • Daly City, CA
  • NPI 1336117829
  Medicare reassignment NPD
• Btdi JV, LLP

  • Physiological Laboratory
  • San Antonio, TX
  • NPI 1194117853
  NPD
• Btdi JV, LLP

  • Physiological Laboratory
  • Austin, TX
  • NPI 1821480583
  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796

  Diagnostic Radiology

  NPD
• Scott and White Clinic

  • Radiation Oncology Physician
  • Waxahachie, TX
  • NPI 1821475153

  Diagnostic Radiology

  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

• Baylor Scott & White Medical Centers - Capitol Area

  • General Acute Care Hospital
  • Buda, TX
  • NPI 1144781501
  Care Compare affiliation
• Baylor Scott & White Medical Centers - Capitol Area

  • General Acute Care Hospital
  • Pflugerville, TX
  • NPI 1346729159
  Care Compare affiliation
• Baylor Scott & White Medical Centers - Capitol Area

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1902366305
  Care Compare affiliation
• Scott & White Hospital - Marble Falls

  • General Acute Care Hospital
  • Marble Falls, TX
  • NPI 1396138970
  Care Compare affiliation
• Scott & White Hospital - Round Rock

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1265568638
  Care Compare affiliation

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1578767182",
    "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": "254-724-8800",
            "fax_number": "254-724-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNIVERSITY BLVD BLDG A",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Sullivan Ave",
            "address_purpose": "LOCATION",
            "city": "Daly City",
            "state": "CA",
            "postal_code": "940152200",
            "country_code": "US",
            "telephone_number": "650-991-6503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "CARL",
        "middle_name": "IN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A99670",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R6030",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "R6030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A996700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00480248",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Lena Khoury-Dennis, PHARM. D.
• Matthew Khuong, CAA
• Nancy N Kidd, RNFA
• Kids First Pediatric Dentistry
• Heidi C Kiehl, R.D.
• Jiho Kim
• Michael Kim, MD
• Min Kim
• Sunmi Kim, COTA
• Kevin Kimbell, CPO

• Vascular & Interventional Radiology Physician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Vascular & Interventional Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.