Individual provider Active NPI

Dean Donghyun Kim, DPM

  • Podiatrist
  • Frisco, TX
National Provider Identifier
1659891836
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
3021 Issued in TX
Practice address
12500 Lebanon Rd
Ste 140
Frisco, TX 75035-9472
Phone
(877) 456-2726
NPI assigned
Jun 20, 2017
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 3021 TX Primary

Addresses

Primary practice location

12500 Lebanon Rd
Ste 140
Frisco, TX 75035-9472

Mailing address

12500 Lebanon Rd
Ste 140
Frisco, TX 75035-9472
Phone (877) 456-2726

Other practice location 1

22999 Highway 59 N
Kingwood, TX 77339-4412
Phone (281) 531-4100

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200623002780 TX Practitioner - Podiatry 0042632978 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12500 Lebanon Rd
Suite 104
Frisco, TX 75035-9474
Phone (469) 384-2135

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of skin lesions16
Removal of nail tissue119
Removal or shaving of skin growth42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3021TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist CurrentSince Jul 1, 2021 Accepting new patients
Preferred Podiatry Group PC Podiatrist CurrentSince Jul 1, 2021 Accepting new patients
Greater Texas Foot & Ankle Specialist Limited Liability Company Podiatrist CurrentSince Dec 1, 2021 Accepting new patients

Locations

3706 Adelphi Ln
Austin, TX 78727
Phone (512) 833-9253

1500 Sunset Dr
Friendswood, TX 77546
Phone (281) 922-4300

12500 Lebanon Rd
Ste 104
Frisco, TX 75035
Phone (469) 384-2135

12500 Lebanon Rd
Ste 140
Frisco, TX 75035

7887 Cambridge St
Houston, TX 77054
Phone (713) 796-2777

7801 N Richland Blvd
North Richlnd Hls, TX 76180
Phone (469) 609-9044

6600 9th Ave
Port Arthur, TX 77642
Phone (409) 962-5541

1 Heartland Dr
San Antonio, TX 78247
Phone (210) 510-3200

2003 W Hutchins Pl
San Antonio, TX 78224
Phone (210) 927-0800

109 N McKinney St
Sweeny, TX 77480
Phone (409) 548-3383

Interoperability endpoints

  • Direct secure messaging: dean.kim.1@19643.direct.athenahealth.com
  • Direct secure messaging: dean.kim@gtfaas-tx.direct.office.nextgen.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1659891836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 LEBANON RD",
            "address_2": "STE 140",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750359472",
            "telephone_number": "877-456-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 LEBANON RD",
            "address_2": "STE 140",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750359472",
            "telephone_number": "877-456-2726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22999 Highway 59 N",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773394412",
            "country_code": "US",
            "telephone_number": "281-531-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DEAN",
        "middle_name": "DONGHYUN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "3021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.