John Andrew Kim, DO
Individual provider Active NPI Family Medicine Physician · Whitefish Bay, WI
NPI 1861070518 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1861070518
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 77475-21 (WI)
- Practice address
- 325 E Silver Spring Dr
Whitefish Bay, WI 53217-5222 - Phone
- (414) 247-4800
- NPI assigned
- Apr 1, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Advanced Healthcare, Inc.
Practice addresses (Care Compare)
325 E Silver Spring Dr
Whitefish Bay, WI 53217-5222
Phone (414) 247-4800
Hospital & facility affiliations
- Aurora at Home
- Aurora Medical Center
- Aurora St Lukes Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240731001536 | WI | Practitioner - Family Practice | 8325416944 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77475-21 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Family Medicine | Current |
Accepting new patients |
Locations
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
325 E Silver Spring Dr
Whitefish Bay, WI 53217
Phone (414) 247-4800
Interoperability endpoints
- jkim231133@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 77475-21 | WI | Yes |
Addresses
Primary practice location
325 E Silver Spring Dr
Whitefish Bay, WI 53217-5222
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100216236 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jkim231133@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Whitefish Bay, WI
- Kettia JN Baptiste
- Madeline Joerres
- Jordan a Moore MD SC
- Chantry R Ketterhagen
- Alexis Killian
- Jodi Kittel
- Ann Marie Clare Klimas
- Cole Klotz
- Katy Kujala-Korpela
- Laura Kunkel
All providers in Whitefish Bay, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.