Individual provider Active NPI

Jaehee Kim, M.D.

  • Hospitalist Physician
  • Philadelphia, PA
National Provider Identifier
1578854824
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A153357 Issued in CA
Practice address
909 Walnut St
2ND Floor
Philadelphia, PA 19107
Phone
(215) 955-7000
Fax
(215) 503-7007
NPI assigned
Apr 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD456150 PA
Internal Medicine Physician 207R00000X A153357 CA
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X A153357 CA Primary

Addresses

Primary practice location

909 Walnut St
2ND Floor
Philadelphia, PA 19107

Mailing address

909 Walnut St
2ND Floor
Philadelphia, PA 19107-5211
Phone (215) 955-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180627003286 CA Practitioner - Internal MedicinePractitioner - Hospitalist 5092022053 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Boston University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

99 Montecillo Rd
San Rafael, CA 94903-3308
Phone (415) 444-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Oakland/Richmond Hospital, Oakland, CA, CCN 050075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153357CAMDInternal Medicine Physician
MD456150PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine CurrentSince Nov 14, 2020 Accepting new patients
Vituity Hospitalists PC Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 14, 2020 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Jun 1, 2018 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Vituity Hospitalists PC Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Galen Inpatient Physicians Inc Internal Medicine CurrentSince Jun 1, 2018 Accepting new patients
Vituity Hospitalists PC Internal Medicine Current Accepting new patients
California Emergency Physicians Medical Group, a Professional Corp Past Accepting new patients
Cep America - California Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

2175 Rosaline Ave
Redding, CA 96001
Phone (530) 225-7247

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

1359 Pine St
San Francisco, CA 94109
Phone (415) 290-6004

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 11

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 1

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1578854824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-955-7000",
            "fax_number": "215-503-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-7000",
            "fax_number": "215-503-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAEHEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD456150",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A153357",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A153357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Road",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.