Active NPI
Nathaniel Jinyoung Kim, MD
- Cardiovascular Disease Physician
- Tucson, AZ
National Provider Identifier
1649807967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 69599
- Practice address
- 1501 N Campbell Ave Ste 5153
Tucson, AZ 85724-3715 - Phone
- (520) 626-1232
- NPI assigned
- Mar 25, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01100164A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Cardiovascular Disease Physician | 207RC0000X | 69599 | AZ | Primary |
Addresses
Primary practice location
1501 N Campbell Ave Ste 5153
Tucson, AZ 85724-3715
Mailing address
743 Spring St NE Ste 710
Gainesville, GA 30501-3715
Phone (770) 219-8730
Other practice location 1
8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992
Phone (317) 338-6666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260519001003 | IN | Practitioner - Internal Medicine | 7416386198 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Indiana University School of Medicine, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11735 | GA | MD | Pharmacist |
| 01100164A | IN | MD | Internal Medicine Physician |
| 69599 | AZ | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1649807967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "743 SPRING ST NE STE 710",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013715",
"telephone_number": "770-219-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 N CAMPBELL AVE STE 5153",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857243715",
"telephone_number": "520-626-1232"
}
],
"practiceLocations": [
{
"address_1": "8333 Naab Rd Ste 420",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462601992",
"country_code": "US",
"telephone_number": "317-338-6666",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "NATHANIEL",
"middle_name": "JINYOUNG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-25",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01100164A",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "AZ",
"license": "69599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.