Individual provider Active NPI

Ki Yu Kim, MD

  • Family Medicine Physician
  • Urbana, MD
National Provider Identifier
1861018129
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0101651 Issued in MD
Practice address
3501 John Simmons St Ste A201
Urbana, MD 21704-7964
Phone
(240) 699-1050
Fax
(410) 367-2353
NPI assigned
Jun 23, 2020
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351046236 MI
Family Medicine Physician 207Q00000X D0101651 MD Primary

Addresses

Primary practice location

3501 John Simmons St Ste A201
Urbana, MD 21704-7964

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (667) 306-7130

Other practice location 1

G3230 Beecher Rd Ste 1
Flint, MI 48532-3604
Phone (810) 342-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231128000095 DC Practitioner - Family Practice 0749603298 Reassigns benefits to 1 organization
I20241231003672 MD Practitioner - Family Practice 0749603298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians
Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, shared by 7 NPIs, 764 clinicians

Practice addresses (Care Compare)

187 Thomas Johnson Dr
Frederick, MD 21702-4503

3501 John Simmons St
Suite A201
Urbana, MD 21704-7964
Phone (240) 699-1050

4224 Altamont PL
Suite 201
White Plains, MD 20695-3052
Phone (240) 607-1500

45 Thomas Johnson Dr
Frederick, MD 21702-4425

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0101651MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc CurrentSince Dec 1, 2024 Accepting new patients
Inova Physician Partners, LLC Family Medicine CurrentSince Nov 13, 2023 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Dec 1, 2024 Accepting new patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients
Johns Hopkins Community Physicians, Inc Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Inova Health Care Services PastSince Nov 13, 2023 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

3501 John Simmons St
Ste A201
Urbana, MD 21704
Phone (240) 699-1050

4224 Altamont PL Ste 201
Ste 201
White Plains, MD 20695
Phone (240) 607-1500

6101 Redwood Square Ctr
Ste 200
Centreville, VA 20121
Phone (703) 631-0331

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

Interoperability endpoints

  • Direct secure messaging: kkim1312738@direct.hopkinsmedicine.org

Organizations & group practices 9

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": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1861018129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "667-306-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHN SIMMONS ST STE A201",
            "city": "URBANA",
            "state": "MD",
            "postal_code": "217047964",
            "telephone_number": "240-699-1050",
            "fax_number": "410-367-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "G3230 Beecher Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323604",
            "country_code": "US",
            "telephone_number": "810-342-5656",
            "fax_number": "810-342-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KI YU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351046236",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0101651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, MD

Sources for this page

Verify at the official NPI Registry.