NPIMap

Individual provider Active NPI

Grace P Kim, MD

  • Infectious Disease Physician
  • Bridgeport, CT
National Provider Identifier
1720036700
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
031353 Issued in CT
Practice address
4699 Main St Ste 201
Bridgeport, CT 06606-1830
Phone
(203) 659-1599
Fax
(203) 382-0189
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 031353 CT Primary

Addresses

Primary practice location

4699 Main St Ste 201
Bridgeport, CT 06606-1830

Mailing address

PO Box 797
Wilton, CT 06897-0797
Phone (203) 659-1599

Other practice location 1

2660 Main St
Suite 221
Bridgeport, CT 06606-5369
Phone (203) 659-1599

Other identifiers 1

IdentifierTypeStateIssuer
001313535MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215001647 PA Practitioner - Internal MedicinePractitioner - Infectious Disease 2466463716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reading HospitalGroup PAC ID 7618886490, 179 clinicians

Practice addresses (Care Compare)

301 S 7TH Ave
Suite 120 Inf Dis and Travel Med
West Reading, PA 19611-1449
Phone (484) 628-4630

Hospital & facility affiliations

  • Reading Hospital Hospital, West Reading, PA, CCN 390044

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Quality
77.19
Promoting interoperability
98
Improvement activities
40
Cost
79.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031353CTMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital CurrentSince Dec 1, 2023 Accepting new patients
Reading Hospital CurrentSince Dec 1, 2023 Accepting new patients
Reading Hospital Current Accepting new patients
Reading Professional Services Past Accepting new patients

Locations

301 S 7th Ave
Ste 120
West Reading, PA 19611
Phone (484) 628-4630

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

Interoperability endpoints

  • Direct secure messaging: grace.kim@xdr.hhchealthdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1720036700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068970797",
            "telephone_number": "203-659-1599",
            "fax_number": "203-382-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST STE 201",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061830",
            "telephone_number": "203-659-1599",
            "fax_number": "203-382-0189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2660 Main St",
            "address_2": "Suite 221",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066065369",
            "country_code": "US",
            "telephone_number": "203-659-1599",
            "fax_number": "203-659-1599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GRACE",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CT",
            "license": "031353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001313535",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.