Leeshah Kim

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

Practice address

1412 Milstead Ave NE
Conyers, GA 30012-3877

Phone

(770) 918-3000

NPI assigned

Jul 11, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, IN2 enrollments

Enrollment records 2

Specialty

Anesthesiology Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Porter County Anesthesia Associates PCGroup PAC ID 4789573411, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Porter County Anesthesia Associates PC

  • Anesthesiology Physician
  • Valparaiso, IN
  • NPI 1215974936

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Rockdale Anesthesia Services, P.C.

  • Anesthesiology Physician
  • Conyers, GA
  • NPI 1619028396

  Single Specialty

  Medicare reassignment NPD

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

• Porter Hospital LLC

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625961600000",
    "number": "1629640628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BISCAYNE DR NW UNIT 203",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091076",
            "telephone_number": "404-422-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-918-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LEESHAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lk770@mynsu.nova.edu",
            "affiliation": "N",
            "address_1": "1 Biscayne Dr NW Unit 203",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303091076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Osman Khan, D.M.D.
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• Kids Speech and OT
• Daniel Mark Kim
• Jin Moo Kim
• Kimberly a Peters DMD PC
• Kimble Care Medical Services
• Heavenly Kimes
• Kindcare Transportation LLC
• Aliyah Kindell, LPC

• Anesthesiologist Assistant in Conyers, GA
• Providers in Conyers, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.