Individual provider Active NPI

Yun Ju Kim, M.D.

  • Gastroenterology Physician
  • Crown Point, IN
National Provider Identifier
1841524683
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
01079054A Issued in IN
Practice address
1205 S Main St Ste 201
Crown Point, IN 46307-3677
Phone
(219) 663-6520
NPI assigned
Sep 27, 2009
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 01079054A IN Primary
Internal Medicine Physician 207R00000X 01079054A IN

Addresses

Primary practice location

1205 S Main St Ste 201
Crown Point, IN 46307-3677

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

27005 76th Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-4462

Other practice location 2

8895 Broadway
Merrillville, IN 46410-7037
Phone (219) 738-2081

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ykim411889@Direct.FranciscanAlliance.org Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231004003461 IL Practitioner - Gastroenterology 9234496704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

2011 York Rd
Suite 1300
Oak Brook, IL 60523-2156
Phone (630) 724-1300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy93
Upper gastrointestinal (GI) endoscopy for acid reflux50

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

2011 York Rd
Ste 1300
Oak Brook, IL 60523
Phone (630) 724-1300

2011 York Rd
Oak Brook, IL 60523
Phone (312) 942-6100

Interoperability endpoints

  • Direct secure messaging: ykim411889@direct.franciscanalliance.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1254009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1841524683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S MAIN ST STE 201",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463073677",
            "telephone_number": "219-663-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-4462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8895 Broadway",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464107037",
            "country_code": "US",
            "telephone_number": "219-738-2081",
            "fax_number": "219-736-4658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YUN JU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-27",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01079054A",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01079054A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ykim411889@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1205 S Main St Ste 201",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463073677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.