Samuel Taesun Kim, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

J1-0014309 Issued in DE

Practice address

540 S College Ave
Newark, DE 19713-1302

Phone

(302) 831-8893

NPI assigned

Jan 21, 2021

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

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chapmanpt, LLCGroup PAC ID 3678985488, 4 clinicians

Prime Physical Therapy LLCGroup PAC ID 7012274525, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Chapmanpt, LLC

  • Orthopedic Physical Therapist
  • Baltimore, MD
  • NPI 1346853157
  Medicare reassignment Care Compare group
• Primephysicaltherapyllc

  • Physical Therapy Clinic/Center
  • Eldersburg, MD
  • NPI 1154868172
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1760072037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 S COLLEGE AVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131302",
            "telephone_number": "302-831-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S COLLEGE AVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131302",
            "telephone_number": "302-831-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SAMUEL",
        "middle_name": "TAESUN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0014309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Min Joo Kim
• Nancy Kim, MD
• Nancy T. Kim, CRNA
• Rubi Kim, PA-C
• Samuel H Kim, PA-C
• Sofia F Kim, MD
• Tae Min Kim, M.D.
• Yoon Ji Kim
• George Kimbiris, MD
• Annah M Kinaro, RN

• Physical Therapist in Newark, DE
• Providers in Newark, DE by specialty
• Physical Therapist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.