NPIMap

Individual provider Active NPI

Michael Kim, M.D.

  • Diagnostic Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1831583772
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
75320 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-3750
Fax
(414) 259-9290
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 75320 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-3750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200627000090 IL Practitioner - Diagnostic Radiology 6406151299 Reassigns benefits to 1 organization
I20210622003027 WI Practitioner - Diagnostic Radiology 6406151299 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1905 N Calhoun Rd
Brookfield, WI 53005-5036

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 19, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 13, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2020 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 13, 2021 Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 1725
Chicago, IL 60611
Phone (312) 664-8533

676 N Saint Clair St
Ste 800
Chicago, IL 60611
Phone (312) 695-5753

251 E Huron St
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1905 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 333-0040

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: mkim512673@direct.froedtert.com

Organizations & group practices 6

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 7

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1831583772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "75320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.