Individual provider Active NPI

Joseph Sun Kim, DPM

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1821096785
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004326 Issued in IL
Practice address
5140 N California Ave
Ste 515
Chicago, IL 60625-3645
Phone
(773) 989-1699
Fax
(773) 989-1698
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016004326 IL
Podiatrist 213E00000X 016004326 IL Primary

Addresses

Primary practice location

5140 N California Ave
Ste 515
Chicago, IL 60625-3645

Mailing address

5140 N California Ave
Ste 515
Chicago, IL 60625-3645
Phone (773) 989-1699

Other identifiers 2

IdentifierTypeStateIssuer
016004326MedicaidIL
IL5729OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090430000458 IL Practitioner - Podiatry 1355408832 Reassigns benefits to 1 organization
Practice locations: Chicago, IL; Niles, IL; Cicero, IL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weil Foot and Ankle Institute LLCGroup PAC ID 4587655105, 56 clinicians

Practice addresses (Care Compare)

1660 Feehanville Dr
Suite 100
Mount Prospect, IL 60056-6019
Phone 84739076666205

Hospital & facility affiliations

  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

Merit-based Incentive Payment System (MIPS)

Final score
76.41 of 100Reported as individual
Quality
43.3
Promoting interoperability
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions26
Removal of nail tissue578
Removal or shaving of skin growth268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
016004326ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Weil Foot and Ankle Institute LLC Podiatrist CurrentSince Nov 1, 2023 Accepting new patients
Weil Foot and Ankle Institute LLC Podiatrist CurrentSince Nov 1, 2023 Accepting new patients
Weil Foot and Ankle Institute LLC Current Accepting new patients
Prime Medical Associates LTD Past Accepting new patients
Center for Seniors Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 203
Bannockburn, IL 60015
Phone 8473907666 ext. 6239

5215 N California Ave
Ste F605
Chicago, IL 60625

1660 Feehanville Dr
Ste 100
Mt Prospect, IL 60056
Phone (847) 627-4924

Interoperability endpoints

  • Direct secure messaging: joseph.kim@weil.emadirect.md

Organizations & group practices 5

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 1

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1821096785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE",
            "address_2": "STE 515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-989-1699",
            "fax_number": "773-989-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE",
            "address_2": "STE 515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-989-1699",
            "fax_number": "773-989-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOSEPH",
        "middle_name": "SUN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004326",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004326",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL5729",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.