Kyung Rae Kim, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

1015353 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-6000

NPI assigned

Aug 26, 2008

Last updated

Sep 6, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC, 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

Specialty

Interventional RadiologyAlso: Diagnostic Radiology

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Children's Hospital Radiology Foundation, Inc.Group PAC ID 6901800861, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boston Children's Hospital Hospital, Boston, MA, CCN 223302

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkim22874@direct.bostonchildrens.org

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.

• Children's Hospital Radiology Foundation, Inc.

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1487681912
  Medicare reassignment Care Compare group NPD
• Chatham Imaging Services of Pittsboro, LLC

  • Physiological Laboratory
  • Pittsboro, NC
  • NPI 1669834131
  NPD (past)
• University of North Carolina

  • General Acute Care Hospital
  • Chapel Hill, NC
  • NPI 1790881118
  NPD (past)

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

• Children's Hospital Corporation

  dba Boston Children's Hospital

  • Children's Hospital
  • Boston, MA
  • NPI 1710087127
  Care Compare affiliation

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1609023282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNG RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1015353",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2009-00713",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "1015353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jung Won Kim, M.D.
• Kendra Kim, OD
• Kevin Sokhan Kim, RPH
• Kiryung Kim
• Kubinne Kim, MD
• Kyung Won Kim, M.D.
• Laura Kim, R.D., L.D.N.
• Lauren M Kim, M.D.
• Leah Sun Kim
• Leo Am Kim, M.D., PH.D.

• Vascular & Interventional Radiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Vascular & Interventional Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.