Individual provider Active NPI

Juen Kim, M.D.

  • Allergy & Immunology Physician
  • Philadelphia, PA
National Provider Identifier
1578862413
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD441135 Issued in PA
Practice address
205 N Broad St
Suite 300
Philadelphia, PA 19107-1554
Phone
(215) 569-1111
Fax
(215) 569-8797
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD441135 PA Primary

Addresses

Primary practice location

205 N Broad St
Suite 300
Philadelphia, PA 19107-1554

Mailing address

205 N Broad St
Suite 300
Philadelphia, PA 19107-1554
Phone (215) 569-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110830000475 PA Practitioner - Allergy/Immunology 9739359704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Michigan Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas E Klein MD PCGroup PAC ID 9133122211, 6 clinicians

Practice addresses (Care Compare)

400 W Township Line Rd
Havertown, PA 19083-5210
Phone (610) 789-1313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD441135PAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas E Klein MD PC CurrentSince Jun 4, 2021 Accepting new patients

Locations

1020 Baltimore Pike
Ste 220
Glen Mills, PA 19342
Phone (610) 459-8191

400 W Township Line Rd
Havertown, PA 19083
Phone (610) 789-1313

1088 W Baltimore Pike
Ste 2106
Media, PA 19063
Phone (610) 566-2126

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

Organizations & group practices 1

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": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1578862413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-569-1111",
            "fax_number": "215-569-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-569-1111",
            "fax_number": "215-569-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD441135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.