Stanley T Kim, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

151887 Issued in CA

Practice address

2300 Children'S Plaza, No. 9
Children'S Memorial Hospital
Chicago, IL 60614

Phone

(773) 880-6792

Fax

(773) 880-3517

NPI assigned

Sep 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Diagnostic Radiology

Education

Rush Medical College of Rush University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wishon Radiological Medical Group IncGroup PAC ID 8022065036, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

88.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 36)

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.

• Wishon Radiological Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1528012168
  Medicare reassignment Care Compare group NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment NPD
• Desert Advanced Imaging Medical Center

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1568416147
  Medicare reassignment NPD
• Diagnostic Radiological Imaging

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1710931910
  Medicare reassignment NPD
• Fresno Imaging Center

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1659456499
  Medicare reassignment NPD
• Modesto Advanced Diagnostic Imaging Medical Center

  • Diagnostic Radiology Physician
  • Modesto, CA
  • NPI 1730133893
  Medicare reassignment NPD
• Norcal Imaging

  • Diagnostic Radiology Physician
  • Concord, CA
  • NPI 1003965997
  Medicare reassignment NPD
• Pronet Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1528099488
  Medicare reassignment NPD
• Radnet Medical Imaging-San Francisco

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1548345382
  Medicare reassignment NPD
• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment NPD
• Santa Rosa Imaging Medical Center

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1689890444
  Medicare reassignment NPD
• Stockton Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1356538201
  Medicare reassignment NPD

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1790779791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHILDREN'S PLAZA, NO. 9",
            "address_2": "CHILDREN'S MEMORIAL HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-6792",
            "fax_number": "773-880-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CHILDREN'S PLAZA, NO. 9",
            "address_2": "CHILDREN'S MEMORIAL HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-880-6792",
            "fax_number": "773-880-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STANLEY",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-111178",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.111178",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "151887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMMG BLUE SHIELD",
            "identifier": "021622158",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111178",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Si-Eon Kim, MD
• So J Kim, MD
• So Lim Kim, MD
• Soo Jin Kim, ACNP-BC
• Soojin Kim, M.D.
• Stephen Kim, PHARMD, LAC
• Stephen Kim, CPO
• Steve Kwangsun Kim
• Steven Kim
• Sumin Kim, LAPC, ATR

• Vascular & Interventional Radiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Vascular & Interventional Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.