Individual provider Active NPI

Isaac Kim, MD

  • Ophthalmology Physician
  • Rockville, MD
National Provider Identifier
1720729544
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0106325 Issued in MD
Practice address
9601 Blackwell Rd Ste 340
Rockville, MD 20850-3472
Phone
(301) 610-2020
Fax
(301) 662-4044
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0106325 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9601 Blackwell Rd Ste 340
Rockville, MD 20850-3472

Mailing address

420 Mountain Ave FL 4
New Providence, NJ 07974-2736
Phone (908) 458-8333

Other practice location 1

5283 Corporate Dr Ste 201
Frederick, MD 21703-2879
Phone (301) 662-4545

Other practice location 2

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-5253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20260515000138 DC Practitioner - Ophthalmology 1355810789
I20260612001924 MD Practitioner - Ophthalmology 1355810789

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of Ny Upstate Medical University, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

420 Mountain Ave
FL 4
New Providence, NJ 07974-2736

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0106325MDMDOphthalmology Physician

Interoperability endpoints

  • Direct secure messaging: ikim88051@direct.upstate.edu

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1720729544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MOUNTAIN AVE FL 4",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742736",
            "telephone_number": "908-458-8333",
            "fax_number": "908-530-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BLACKWELL RD STE 340",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503472",
            "telephone_number": "301-610-2020",
            "fax_number": "301-662-4044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5283 Corporate Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217032879",
            "country_code": "US",
            "telephone_number": "301-662-4545",
            "fax_number": "301-662-4044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-5253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ISAAC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0106325",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.