NPIMap

Individual provider Active NPI

Michelle M Kim, MD, PHD

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1609213867
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L-255905 Issued in MA
Practice address
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Phone
(617) 726-2800
NPI assigned
May 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 273934 MA
Surgery Physician 208600000X L-255905 MA Primary

Addresses

Primary practice location

Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114

Mailing address

Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Phone (617) 726-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015000513 MA Practitioner - Urology 7214165232 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Perelman School of Med at the University of Pennsylvania, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Martha'S Vineyard Hospital Inc Hospital, Oak Bluffs, MA, CCN 221300
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-255905MAMDSurgery Physician
273934MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha'S Vineyard Hospital, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Martha'S Vineyard Hospital, Inc. CurrentSince Nov 1, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Oct 20, 2018 Accepting new patients
Massachusetts General Physicians Organization Inc Surgery CurrentSince Oct 20, 2018 Accepting new patients
General Hospital Corp Current Accepting new patients
Martha'S Vineyard Hospital, Inc. Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

70 East St
Methuen, MA 01844
Phone (978) 682-1906

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

Interoperability endpoints

  • Direct secure messaging: kim.michelle.mgh@direct.partners.masshiway.net

Organizations & group practices 8

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 3

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": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1609213867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "273934",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "L-255905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.