NPIMap

Individual provider Active NPI

Tae Won Benjamin Kim, MD

  • Orthopaedic Surgery Physician
  • Camden, NJ
National Provider Identifier
1780846246
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
25MA09492900 Issued in NJ
Practice address
3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438
Phone
(856) 342-2000
NPI assigned
Jun 26, 2008
Last updated
Jan 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 268575 NY
Orthopaedic Surgery Physician 207X00000X 25MA09492900 NJ Primary
Orthopaedic Surgery Physician 207X00000X MT192453 PA
Orthopaedic Surgery Physician 207X00000X MD442398 PA

Addresses

Primary practice location

3 Cooper PLZ
Suite 502
Camden, NJ 08103-1438

Mailing address

1 Federal St # 100
Camden, NJ 08103-1088
Phone (856) 356-4924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141020002212 NJ Practitioner - Orthopedic Surgery 4981825775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Surgical Associates, PAGroup PAC ID 3274430764, 303 clinicians

Practice addresses (Care Compare)

900 Centennial Blvd
Suite G
Voorhees, NJ 08043-4637
Phone (856) 325-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.23 of 100Reported as group
Quality
77.64
Promoting interoperability
98
Improvement activities
40
Cost
68.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09492900NJMDOrthopaedic Surgery Physician
268575NYMDOrthopaedic Surgery Physician
MD442398PAMDOrthopaedic Surgery Physician
MT192453PAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Surgical Associates, PA Orthopaedic Surgery CurrentSince Aug 10, 2014 Accepting new patients
Cooper Bone and Joint Institute Orthopaedic Surgery Past Accepting new patients
The Cooper Health System Past Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Rm 220
Camden, NJ 08103
Phone (856) 342-2228

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 502
Camden, NJ 08103
Phone (856) 342-2921

1878 Route 70 E
Ste 5
Cherry Hill, NJ 08003
Phone (856) 375-2440

401 Kings Hwy S
Ste 3A
Cherry Hill, NJ 08034
Phone (609) 795-7951

2 Plaza Dr
Sewell, NJ 08080
Phone (856) 270-4150

900 Centennial Blvd
Ste 203
Voorhees, NJ 08043
Phone (856) 325-6674

900 Centennial Blvd
Ste G
Voorhees, NJ 08043
Phone (856) 325-6565

651 John F Kennedy Way
Willingboro, NJ 08046
Phone (609) 835-2838

Interoperability endpoints

  • Direct secure messaging: tkim37875@direct.cooperhealth.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1780846246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 100",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924",
            "fax_number": "856-356-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 502",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAE WON",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "268575",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA09492900",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MT192453",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD442398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.