Active NPI
Brian K. Kim, M.D.
- Hematology & Oncology Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- ME66697
- Practice address
- 3840 Broadway
Fort Myers, FL 33901-8108 - Phone
- (239) 275-6400
- Fax
- (239) 275-0178
- NPI assigned
- Nov 4, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | ME66697 | FL | Primary |
Addresses
Primary practice location
3840 Broadway
Fort Myers, FL 33901-8108
Mailing address
4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916-2216
Phone (239) 274-8200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 375598300 | Medicaid | FL | |
| 830004833 | Other | FL | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Cancer Specialists & Research Institute, LLC | Hematology & Oncology | Current | Accepting new patients |
Locations
811 Del Prado Blvd S
Fl Cancer
Cape Coral, FL 33990
Phone (239) 772-3544
4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500
15681 New Hampshire Ct
Fl Cancer
Fort Myers, FL 33908
Phone (239) 437-4444
3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400
1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780
Organizations & group practices 1
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.
-
- Medical Oncology Physician
- Cape Coral, FL
- NPI 1760590962
Hematology & Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276128000000",
"number": "1861483166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4371 VERONICA S SHOEMAKER BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339162216",
"telephone_number": "239-274-8200",
"fax_number": "239-278-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3840 BROADWAY",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339018108",
"telephone_number": "239-275-6400",
"fax_number": "239-275-0178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BRIAN",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2010-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "FL",
"license": "ME66697",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "375598300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "830004833",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.