Jae Y Kim, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

0101259733 Issued in VA

Practice address

2200 Wilson Blvd Ste 102-219
Arlington, VA 22201-3397

Phone

(347) 551-1113

NPI assigned

May 12, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, PA, DC3 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 3

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

State University of New York at Buffalo School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Ridge Orthopaedic Associates PCGroup PAC ID 6800885310, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fauquier Hospital Hospital, Warrenton, VA, CCN 490023
• Reston Hospital Center Hospital, Reston, VA, CCN 490107

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jae.kim.p1@direct.fauquierent.nextgenshare.com

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.

• Blue Ridge Orthopaedic Associates PC

  dba Blue Ridge Orthopaedic & Spine Center

  • Orthopaedic Surgery Physician
  • Warrenton, VA
  • NPI 1508959701
  Medicare reassignment Care Compare group NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• You Are Beautiful Aesthetic Institute, PLLC

  • Facial Plastic Surgery Physician
  • Fairfax, VA
  • NPI 1932948023
  NPD Authorized official
• You Are Beautiful Surgical Center

  dba Capital Cosmetic Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Fairfax, VA
  • NPI 1801639737
  NPD Authorized official
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Mountain Top, PA
  • NPI 1922392372
  NPD

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

• Fauquier Medical Center LLC

  dba Fauquier Health

  • General Acute Care Hospital
  • Warrenton, VA
  • NPI 1912334517
  Care Compare affiliation
• Reston Hospital Center LLC

  dba Reston Hospital Center

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  Care Compare affiliation

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1609168327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 WILSON BLVD STE 102-219",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WILSON BLVD STE 102-219",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013397",
            "telephone_number": "347-551-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_2": "Otolaryngology",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-628-4368",
            "fax_number": "804-828-8299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "VA",
            "license": "0101259733",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101259733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duke H Kim, DDS MAGD
• Elizabeth Sangah Kim, M.D.
• Eric Jeonghyun Kim
• Eunae Kim
• Jae S. Kim, DDS
• Michelle Kim, M. CL. SC.
• Nancy Carol Kim, MD
• Rebecca Anne Wyckoff Kim, PHD
• Shawn J Kim, DMD
• Yeo Lim Kim

• Facial Plastic Surgery Physician in Arlington, VA
• Providers in Arlington, VA by specialty
• Facial Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.