Individual provider Active NPI

Ho Jin Kim, M.D.

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1639276363
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
K0092 Issued in TX
Practice address
6606 LBJ Fwy
Suite 200
Dallas, TX 75240-6533
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X K0092 TX Primary

Addresses

Primary practice location

6606 LBJ Fwy
Suite 200
Dallas, TX 75240-6533

Mailing address

PO Box 650865
Dallas, TX 75265-0865
Phone (972) 715-5000

Other identifiers 4

IdentifierTypeStateIssuer
0086JLOtherTXBCBS
8R1208OtherTXBCBS
125508505MedicaidTX
125508506MedicaidTX

Other names 1

  • Dr. Glenn Kim Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060112001016 TX Practitioner - Anesthesiology 0244253458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Texas Tech University Health Science Center School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

2930 N Stanton St
El Paso, TX 79902-2511
Phone (915) 271-4569

Hospital & facility affiliations

  • Sierra Medical Center Hospital, El Paso, TX, CCN 450668

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Nov 30, 2017 Accepting new patients
BHS Physicians Network, Inc CurrentSince Nov 30, 2017 Accepting new patients
Anesthesia Consultants, Associated Anesthesiology Past Accepting new patients
Providence Imaging Consultants, P.a. Past Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

125 W Castellano Dr
El Paso, TX 79912
Phone (915) 532-8200

2930 N Stanton St
El Paso, TX 79902
Phone (915) 271-4569

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

10301 Gateway Blvd W
El Paso, TX 79925
Phone (915) 543-2424

2001 N Oregon St
El Paso, TX 79902
Phone (915) 577-6011

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1639276363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650865",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650865",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406533",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HO JIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K0092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0086JL",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8R1208",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125508505",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125508506",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENN",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.