Individual provider Active NPI

Eunyoung Rachel Kim, P.A.-C

  • Surgical Physician Assistant
  • New Brunswick, NJ
National Provider Identifier
1619150448
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00198700 Issued in NJ
Practice address
1 RWJ Place
Robert Wood Johnson University Hospital
New Brunswick, NJ 08901
Phone
(732) 390-0040
Fax
(732) 390-1856
NPI assigned
Dec 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012293 NY
Surgical Physician Assistant 363AS0400X 25MP00198700 NJ Primary

Addresses

Primary practice location

1 RWJ Place
Robert Wood Johnson University Hospital
New Brunswick, NJ 08901

Mailing address

579A Cranbury Rd.
East Brunswick, NJ 08816
Phone (732) 390-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000621 NJ Practitioner - Physician Assistant 5496830226 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Radiology Group LLCGroup PAC ID 6608868500, 239 clinicians

Practice addresses (Care Compare)

1 RWJ PL
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600

579 A Cranbury Rd
East Brunswick, NJ 08816-5426
Phone (732) 390-0040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.93 of 100Reported as group
Quality
95.96
Improvement activities
40
Cost
73.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012293NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hillsborough Radiology Centers, LLC Current Accepting new patients

Locations

579A Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

483 Cranbury Rd
East Brunswick, NJ 08816
Phone (732) 390-0030

Organizations & group practices 3

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": "1197676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1619150448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579A CRANBURY RD.",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "08816",
            "telephone_number": "732-390-0040",
            "fax_number": "732-390-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RWJ PLACE",
            "address_2": "ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-390-0040",
            "fax_number": "732-390-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUNYOUNG",
        "middle_name": "RACHEL",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-15",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012293",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00198700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.