Andrew Jongsoo Kim, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

ME158534 Issued in FL

Practice address

5151 N 9TH Ave
Pensacola, FL 32504-8721

Phone

(850) 416-1900

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, FL, NY, CO4 enrollments

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 4

Specialty

NeurologyAlso: Pediatric Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (11 of 12)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Children'S Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653

  CA

  Medicare reassignment Care Compare group NPD
• Sacred Heart Health System, Inc.

  • Ambulatory Family Planning Facility
  • Pensacola, FL
  • NPI 1962453308

  FL

  Medicare reassignment NPD
• Obstetrix Medical Group of Colorado P C

  • Neonatal-Perinatal Medicine Physician
  • Denver, CO
  • NPI 1700983103

  CO

  Medicare reassignment NPD
• Sacred Heart Health System Inc

  • Community/Retail Pharmacy
  • Pensacola, FL
  • NPI 1366260739
  NPD
• Sacred Heart Health System, Inc.

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1144271586
  NPD
• Obstetrix Medical Group of Colorado P C

  • Pediatric Cardiology Physician
  • Denver, CO
  • NPI 1497779276
  NPD
• Pediatrix Medical Group of Michigan PC

  • Neonatal-Perinatal Medicine Physician
  • Sunrise, FL
  • NPI 1720185432
  NPD (past)
• Ann & Robert H Lurie Childrens Hospital of Chicago

  • Children's Hospital
  • Chicago, IL
  • NPI 1538279518
  NPD (past)
• Benefis Hospitals, Inc.

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1881650737
  NPD (past)
• Children'S Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)
• Childrens Hospital of Los Angeles

  • Children's Hospital
  • Los Angeles, CA
  • NPI 1124073366
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1699856237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "middle_name": "JONGSOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME158534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A629450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Kilgore, PTA
• John Thomas Killian, MD
• Amanda Killinger, DO
• Jeanne Allen Killingsworth
• Kelcey Killingsworth, PHD, LMHC, NCC
• Esther Hyojin Kim, RN
• Eudeum Lee Kim, APRN
• Tracey Kim, DO
• Karin Kimberl, LMHC
• William Dolphus Kimbrell IV, APRN, FNP-C

• Neurology with Special Qualifications in Child Neurology Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.
• 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.