Mary Kim

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0038587 Issued in OH

Practice address

11100 Euclid Ave
Cleveland, OH 44106-1716

Phone

(917) 705-3982

NPI assigned

Aug 13, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Hospitals Cleveland Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1043397292
  Care Compare affiliation
• University Hospitals Cleveland Medical Center

  • Multi-Specialty Clinic/Center
  • Mentor, OH
  • NPI 1487770335

  Hospital

  Care Compare affiliation
• University Hospitals Cleveland Medical Center

  • Multi-Specialty Clinic/Center
  • Westlake, OH
  • NPI 1669598082

  Hospital

  Care Compare affiliation
• University Hospitals of Cleveland

  • Clinic/Center
  • Cleveland, OH
  • NPI 1760673412

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1861378994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6877 SILKWOOD LN",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441395078",
            "telephone_number": "917-705-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "917-705-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0038587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Il-Chung Kim, M.D.
• June L Kim, ACNP
• Jungnam E Kim, DMD
• Lisa Kibum Asamoto Kim, MD
• Luke Dogyun Kim, MD
• Rebecca Kim, APRN
• Roy J Kim, M.D.
• Sallie Kim, RN
• Sandra C Kim, MD
• Shinseung Kim

• Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.