Individual provider Active NPI

David Daewhan Kim, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Detroit, MI
National Provider Identifier
1609940113
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
4301066691 Issued in MI
Practice address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone
(313) 916-2436
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301066691 MI
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 4301066691 MI Primary

Addresses

Primary practice location

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202

Mailing address

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-2436

Other identifiers 4

IdentifierTypeStateIssuer
250Q260840OtherBLUE CROSS-BLUE CROSS
DK066691OtherCHAMPUS-CHAMPUS
DK066691OtherCOMMERCIAL-COMMERCIAL NUMBER
447344610MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090424000491 MI Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Physical Medicine and Rehabilitation 7719035047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
University of Maryland School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 876-2585

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jan 1, 2003 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 2003 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
Henry Ford West Bloomfield Hospital Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
#363
Detroit, MI 48202
Phone (313) 916-2020

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

159 Kercheval Ave
Grosse Pointe Farms, MI 48236
Phone (313) 640-1000

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

24555 Haig St
Taylor, MI 48180
Phone (313) 292-6260

2825 Livernois Rd
Troy, MI 48083
Phone (248) 680-2060

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: dkim16763@direct.hfhs.org

Organizations & group practices 5

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1609940113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "DAEWHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301066691",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "4301066691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "250Q260840",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "DK066691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "DK066691",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447344610",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.