Jacob J Kim, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

98263 Issued in GA

Practice address

41 Mall Rd
Burlington, MA 01805-0001

Phone

(781) 744-5100

NPI assigned

Aug 1, 2006

Last updated

Jan 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Emergency Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gwinnett Emergency Specialists Observation Services LLCGroup PAC ID 7618140955, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score

91.98 of 100Reported as apm

Quality

76.59

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment Care Compare group NPD
• Gwinnett Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1437346467
  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1710993324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JACOB",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "160804",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "98263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110005141A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cyrus Arash Kholdani, MD
• Harriet Kiddu
• Kim Wong DMD PC (Center for Adult Dental Care)
• Cathleen M Kim, M.D.
• Esther Kim, D.O.
• Victoria Kim
• Won Kyung Kim, D.M.D.
• Donna Marie Kimborowicz
• Kindle Behavior Consultants
• Arianne Kindle, BCBA

• Emergency Medicine Physician in Burlington, MA
• Providers in Burlington, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.