Individual provider Active NPI

Daniel Chan Kyum Kim, DO

  • Hospitalist Physician
  • Phoenix, AZ
National Provider Identifier
1740742824
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
009558 Issued in AZ
Practice address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone
(602) 445-0751
Fax
(602) 424-8128
NPI assigned
Apr 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 009558 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 009558 AZ Primary

Addresses

Primary practice location

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Mailing address

9225 N 3Rd St Ste 300
Phoenix, AZ 85020-2466
Phone (602) 445-0751

Other practice location 1

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Other practice location 2

9225 N 3rd St Ste 300
Phoenix, AZ 85020-2466
Phone (602) 445-0751

Other identifiers 2

IdentifierTypeStateIssuer
153907MedicaidAZ
009558OtherAZAZ DO LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20220721003107 AZ Practitioner - Internal MedicinePractitioner - Hospitalist 2567843535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Arizona College of Osteopathic Medicine Mid Western University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Hospitalists PLCGroup PAC ID 6204822869, 84 clinicians

Practice addresses (Care Compare)

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Hospitalists, PLC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Honorhealth Past Accepting new patients

Locations

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

9225 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 870-1821

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

Organizations & group practices 2

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 1

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1740742824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 N 3RD ST STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202466",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084973",
            "country_code": "US",
            "telephone_number": "602-344-5011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9225 N 3rd St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850202466",
            "country_code": "US",
            "telephone_number": "602-445-0751",
            "fax_number": "602-424-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "CHAN KYUM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "009558",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "009558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153907",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DO LICENSE",
            "identifier": "009558",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.