Individual provider Active NPI

So Yeon Kim, MD

  • Medical Oncology Physician
  • North Haven, CT
National Provider Identifier
1760831408
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
72166 Issued in CT
Practice address
6 Devine St
North Haven, CT 06473-2195
Phone
(203) 407-8002
NPI assigned
Jun 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 72166 CT
Medical Oncology Physician 207RX0202X 72166 CT Primary

Addresses

Primary practice location

6 Devine St
North Haven, CT 06473-2195

Mailing address

333 Cedar Street
Www205
New Haven, CT 06510
Phone (203) 785-4095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220907002317 CT Practitioner - Medical OncologyPractitioner - Hematology 9032405980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
Albert Einstein College of Medicine of Yeshiva University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

6 Devine St
North Haven, CT 06473-2195
Phone (203) 287-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Yale University CurrentSince Aug 1, 2022 Accepting new patients
Yale University PastSince Mar 1, 2022 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

333 Cedar St
#205
New Haven, CT 06510
Phone (203) 785-4095

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

6 Devine St
Fl 2
North Haven, CT 06473
Phone (203) 287-6200

6 Devine St
North Haven, CT 06473
Phone (203) 230-3940

Interoperability endpoints

  • Direct secure messaging: skim581902@direct.ynhh.org

Organizations & group practices 3

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1760831408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR STREET",
            "address_2": "WWW205",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-785-4095",
            "fax_number": "203-785-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DEVINE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732195",
            "telephone_number": "203-407-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SO YEON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "CT",
            "license": "72166",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "CT",
            "license": "72166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

Verify at the official NPI Registry.