Jeong H Kim, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD-16105 Issued in HI

Practice address

1401 S Beretania St Ste 320
Honolulu, HI 96814-1872

Phone

(808) 888-0967

Fax

(808) 888-0956

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

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

Specialty

Gastroenterology

Education

Eastern Virginia Medical School, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jeong H Kim MD PLLCGroup PAC ID 8820225121, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jeong.kim@hawaiihie.medicity.net
• Direct secure messaging: jeong.kim1@hawaiihie.medicity.net
• Direct secure messaging: jeong.kim@754.chartlogic.direct-ci.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.

• Jeong H Kim, MD, PLLC

  • Gastroenterology Physician
  • Honolulu, HI
  • NPI 1598190134
  Medicare reassignment Care Compare group Authorized official
• Hawaii Gastroenterology Specialist

  • Gastroenterology Physician
  • Aiea, HI
  • NPI 1790033454
  NPD (past)
• Pacific Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Honolulu, HI
  • NPI 1104246446
  NPD (past)
• Pacific Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Pearl City, HI
  • NPI 1841316841
  NPD (past)

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

• Straub Clinic & Hospital

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1720031701
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619986437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 MOANIALA ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968212571",
            "telephone_number": "808-489-9479",
            "fax_number": "808-888-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST STE 320",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141872",
            "telephone_number": "808-888-0967",
            "fax_number": "808-888-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONG",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "AFE73901",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "54642",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00047928",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "HI",
            "license": "MD-16105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9275116",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "227617",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "9185KI",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8501496",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Honolulu",
            "affiliation": "N",
            "address_1": "1401 S Beretania St Ste 320",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968141872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jane S. Kim
• Jani Mijin Kim
• Jared Kim, MD
• Jean Kim, MD
• Jean Kim
• Jessica Kim
• Jin Kim, D.C.
• Jin Hee Kim, PHARM D
• Jisu Kim, DDS
• Jung H Kim, MD

• Gastroenterology Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Gastroenterology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.