Individual provider Active NPI

Jennifer CHI-Yong Kim, MD

  • Facial Plastic Surgery Physician
  • Boston, MA
National Provider Identifier
1598853004
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
1020316 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3096
Phone
(617) 573-3223
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 1020316 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3096

Mailing address

243 Charles St
Boston, MA 02114-3096
Phone (617) 573-3223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MA2 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

Enrollment IDStateProvider typePAC IDDetails
I20100317000678 MI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 2961537865 Reassigns benefits to 2 organizations
I20241025002954 MA Practitioner - Otolaryngology 2961537865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
State University of New York at Stony Brook, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision30
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Otolaryngology CurrentSince Sep 24, 2002 Accepting new patients
Regents of the University of Michigan CurrentSince Sep 24, 2002 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Otolaryngology CurrentSince Oct 1, 2024 Accepting new patients
Massachusetts Eye and Ear Infirmary Current Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

300 Crown Colony Dr
Ste 201
Quincy, MA 02169
Phone (617) 573-3135

3621 S State St
#700
Ann Arbor, MI 48108

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Fl 1
Ann Arbor, MI 48109
Phone (734) 936-4054

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

19900 Haggerty Rd
Ste 100
Livonia, MI 48152
Phone (248) 432-7801

Interoperability endpoints

  • Direct secure messaging: jkim22277@direct.med.umich.edu
  • Direct secure messaging: kim.jennifer.meei@direct.partners.masshiway.net

Organizations & group practices 7

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 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1598853004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JENNIFER",
        "middle_name": "CHI-YONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MA",
            "license": "1020316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.