Active NPI
Brian Jung Hun Kim, M.D.
- Diagnostic Radiology Physician
- Dallas, TX
National Provider Identifier
1669558367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- A74367
- Practice address
- 2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688 - Phone
- (844) 389-5711
- Fax
- (877) 880-2039
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | R9632 | TX | |
| Diagnostic Radiology Physician | 2085R0202X | A74367 | CA | Primary |
Addresses
Primary practice location
2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Mailing address
2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Phone (844) 389-5711
Other practice location 1
1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A74367 | CA | MD | Diagnostic Radiology Physician |
| R9632 | TX | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Chartered | Diagnostic Radiology | Current | Accepting new patients |
| Cira Michigan PC | Diagnostic Radiology | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Glendale Radiology Medical Group, Inc. | Diagnostic Radiology | Past | Accepting new patients |
| MRI Imaging Institute | Diagnostic Radiology | Past | Accepting new patients |
| Johns Hopkins University | Diagnostic Radiology | Past | Accepting new patients |
| Summit Radiology P C | Diagnostic Radiology | Past | Accepting new patients |
| New Castle Clinic Inc | Diagnostic Radiology | Past | Accepting new patients |
| Imaging Diagnostic Center Limited | Diagnostic Radiology | Past | Accepting new patients |
Locations
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1789 Shawano Ave
Green Bay, WI 54303
Organizations & group practices 9
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.
-
- Diagnostic Radiology Physician
- Green Bay, WI
- NPI 1760416895
-
- Diagnostic Radiology Physician
- Escanaba, MI
- NPI 1972141513
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Diagnostic Radiology Physician
- Glendale, CA
- NPI 1396759726
-
- Diagnostic Radiology Physician
- Fort Wayne, IN
- NPI 1871564336
-
- Diagnostic Radiology Physician
- Glendale, CA
- NPI 1497769814
-
- Diagnostic Radiology Physician
- New Castle, IN
- NPI 1699916031
-
- Diagnostic Radiology Physician
- Fort Wayne, IN
- NPI 1073584587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1669558367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 OAK LAWN AVE UNIT 192749",
"city": "DALLAS",
"state": "TX",
"postal_code": "752194688",
"telephone_number": "844-389-5711",
"fax_number": "877-880-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 OAK LAWN AVE UNIT 192749",
"city": "DALLAS",
"state": "TX",
"postal_code": "752194688",
"telephone_number": "844-389-5711",
"fax_number": "877-880-2039"
}
],
"practiceLocations": [
{
"address_1": "1509 Wilson Ter",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "CA",
"postal_code": "912064007",
"country_code": "US",
"telephone_number": "818-409-8010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "BRIAN",
"middle_name": "JUNG HUN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "R9632",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A74367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.