Timothy Robert Kim, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

33395-020 Issued in WI

Practice address

N15W28300 Golf Rd
Pewaukee, WI 53072-4800

Phone

(262) 544-5311

Fax

(262) 544-6820

NPI assigned

Nov 29, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Anesthesiology

Education

Medical College of Wisconsin, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Associates of Wisconsin SCGroup PAC ID 1052200953, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkim4151@direct.phci.org

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.

• Orthopaedic Associates of Wisconsin, SC

  • Orthopaedic Surgery Physician
  • Pewaukee, WI
  • NPI 1689656951
  Medicare reassignment Care Compare group NPD
• Orthopaedic Associates of Wisconsin SC

  • Orthopaedic Surgery Physician
  • Mukwonago, WI
  • NPI 1720433790
  NPD
• Anesthesiology Associates of Wisconsin, S.C.

  • Anesthesiology Physician
  • Milwaukee, WI
  • NPI 1578518353
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1760465231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N15W28300 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724800",
            "telephone_number": "262-303-5000",
            "fax_number": "262-303-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N15W28300 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724800",
            "telephone_number": "262-544-5311",
            "fax_number": "262-544-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "33395-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00100373",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760465231",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerk Physical Therapy Specialists SC
• Andrew J Kerk, PT
• Ryan Kerstan, R.PH
• Eyad Kholoki, DDS
• Christopher Michael Kilian, M.D
• Matthew C Kinkade, DPT
• Cassandra Jean Lynn Kinnard, LMT
• Denise Kirk, RRT
• Mitchell Robert Klement, M.D
• Meghan Victoria Klinck, PA-C

• Anesthesiology Physician in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.