Pamela Sue Kim

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

280575 Issued in NY

Practice address

Stony Brook Medicine
101 Nicolls Road, HSC T19-090
Stony Brook, NY 11794-0001

Phone

(631) 444-2040

Fax

(631) 444-6031

NPI assigned

Apr 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

General Surgery

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Vein Restoration Ma LLCGroup PAC ID 2961734611, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pamela.kimmd.p3@direct.cvr.nextgenshare.com

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.

• Center for Vein Restoration Ma LLC

  • Surgery Physician
  • Framingham, MA
  • NPI 1518523810
  Medicare reassignment Care Compare group NPD
• Center for Vein Restoration Ma LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Woburn, MA
  • NPI 1861360992
  NPD

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1669799698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "address_2": "STONY BROOK MEDICINE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-2040",
            "fax_number": "631-444-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK MEDICINE",
            "address_2": "101 NICOLLS ROAD, HSC T19-090",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2040",
            "fax_number": "631-444-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "280575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ju Eun Kim, D.O
• Julia Kim, MD
• Julie Minjae Kim, MD
• Kyung Ho Kim, MD
• Min Seong Kim, DO
• Sara Ka Rham Kim, MD
• Soojin Kim
• Tae Joo Kim, RN
• Taesung Kim, DO
• Yuri Kim, MD

• Surgery Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.

Verify at the official NPI Registry.