Individual provider Active NPI

Daniel E Kim, M.D.

  • Surgery Physician
  • New Haven, CT
National Provider Identifier
1639113806
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
68901 Issued in CT
Practice address
330 Cedar St # Bb310
New Haven, CT 06510-3218
Phone
(203) 785-2572
Fax
(203) 785-3950
NPI assigned
Jun 16, 2006
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 68901 CT Primary

Addresses

Primary practice location

330 Cedar St # Bb310
New Haven, CT 06510-3218

Mailing address

2 Perryridge Rd
Greenwich, CT 06830-4608
Phone (210) 727-5794

Other practice location 1

William Beaumont Army Medical Center
5005 N. Piedras St., Attn Credentials
El Paso, TX 79920-5001
Phone (915) 569-2698

Other practice location 2

3698 Chambers Pass Ste B
Fort Sam Houston, TX 78234-7767
Phone (210) 916-2876

Other identifiers 1

IdentifierTypeStateIssuer
100096288MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20210708000803 CT Practitioner - General SurgeryPractitioner - Other (Physician) 6103154034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

5 Perryridge Rd
Greenwich, CT 06830-4608
Phone (203) 863-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jul 1, 2021 Accepting new patients
Yale University Surgery Current Accepting new patients
Yale University CurrentSince Jul 1, 2021 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: dkim519786@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1639113806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PERRYRIDGE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304608",
            "telephone_number": "210-727-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CEDAR ST # BB310",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103218",
            "telephone_number": "203-785-2572",
            "fax_number": "203-785-3950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "WILLIAM BEAUMONT ARMY MEDICAL CENTER",
            "address_2": "5005 N. PIEDRAS ST., ATTN CREDENTIALS",
            "address_purpose": "LOCATION",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001",
            "country_code": "US",
            "telephone_number": "915-569-2698",
            "fax_number": "915-569-2602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3698 Chambers Pass Ste B",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782347767",
            "country_code": "US",
            "telephone_number": "210-916-2876",
            "fax_number": "210-916-0009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "68901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096288",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.