Individual provider Active NPI

Sara Bogeum Kim

  • Family Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1841063179
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R237410 Issued in MD
Practice address
11886 Healing Way # 701
Silver Spring, MD 20904-7917
Phone
(301) 933-3216
NPI assigned
Oct 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R237410 MD Primary

Addresses

Primary practice location

11886 Healing Way # 701
Silver Spring, MD 20904-7917

Mailing address

8057 Brightwood CT
Ellicott City, MD 21043-7935
Phone (301) 661-8222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240129000361 DC Practitioner - Nurse Practitioner 7911350780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Marymount University, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Oncology Hematology PAGroup PAC ID 2062302102, 96 clinicians

Practice addresses (Care Compare)

11886 Healing Way
Suite 701
Silver Spring, MD 20904-7917
Phone (301) 933-3216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Oncology Hematology, P.a. CurrentSince Dec 26, 2023 Accepting new patients
Kashif a Firozvi MD PA Current Accepting new patients
Maryland Oncology Hematology P.a. CurrentSince Dec 26, 2023 Accepting new patients
Maryland Oncology Hematology P.a. PastSince Nov 5, 2023 Accepting new patients

Locations

1160 Varnum St NE
Ste 318
Washington, DC 20017
Phone (202) 636-3811

11720 Beltsville Dr
Ste 300
Beltsville, MD 20705

12200 Annapolis Rd
Ste 118
Glenn Dale, MD 20769
Phone (410) 897-6200

6505 Belcrest Rd
Ste 110
Hyattsville, MD 20782
Phone (202) 449-9634

7350 Van Dusen Rd
Ste 370
Laurel, MD 20707
Phone (301) 982-9800

11886 Healing Way
Ste 701
Silver Spring, MD 20904
Phone (301) 933-3216

Interoperability endpoints

  • Direct secure messaging: sara.kim@mdonc.ikm.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1841063179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8057 BRIGHTWOOD CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210437935",
            "telephone_number": "301-661-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11886 HEALING WAY # 701",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047917",
            "telephone_number": "301-933-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SARA",
        "middle_name": "BOGEUM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R237410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.