Richard Kyungho Kim, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

01074190A Issued in IN

Practice address

1210 Medical Arts Blvd Ste 217B
Anderson, IN 46011-3461

Phone

(765) 298-4470

Fax

(765) 298-4975

NPI assigned

Mar 25, 2009

Last updated

Sep 23, 2021By the provider in NPPES

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 IN

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

Neurosurgery

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

US Therapy IncGroup PAC ID 6507893187, 81 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital of Anderson and Madison County Hospital, Anderson, IN, CCN 150113
• Community Hospital North Hospital, Indianapolis, IN, CCN 150169

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkim130218@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment Care Compare group NPD
• US Therapy Inc.

  dba First Choice Physical Therapy (New Castle)

  • Rehabilitation Clinic/Center
  • New Castle, IN
  • NPI 1841228996
  Care Compare group
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1619163854
  Care Compare affiliation
• Community Hospital of Anderson & Madison County, Inc

  • General Acute Care Hospital
  • Anderson, IN
  • NPI 1972500452
  Care Compare affiliation

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1790927580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 E HAMPDEN AVE #220",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132792",
            "telephone_number": "303-783-8844",
            "fax_number": "303-783-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MEDICAL ARTS BLVD STE 217B",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113461",
            "telephone_number": "765-298-4470",
            "fax_number": "765-298-4975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "499 E HAMPDEN AVE #220",
            "address_purpose": "LOCATION",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132792",
            "country_code": "US",
            "telephone_number": "303-783-8844",
            "fax_number": "303-783-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "RICHARD",
        "middle_name": "KYUNGHO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MT190323",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "55280",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01074190A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300054280",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF PA",
            "identifier": "MT190323",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gaganbir Khaira, MD
• Elias Khalaf, MD
• Khalil G. Wakim MD
• Jahangir Khan
• Nisha Shah Kheradiya, M.D.
• Desiree King
• Jennifer Lynn King, RN
• Mallory King
• Tanner King
• Chris D Kinney, DDS

• Neurological Surgery Physician in Anderson, IN
• Providers in Anderson, IN by specialty
• Neurological Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.