Active NPI
Eun Ae Kim, MD
- Family Medicine Physician
- Hockessin, DE
National Provider Identifier
1861554271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C10008813
- Practice address
- 722 Yorklyn Rd
Suite 400
Hockessin, DE 19707-8718 - Phone
- (302) 235-2351
- Fax
- (302) 235-2365
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C10008813 | DE | Primary |
Addresses
Primary practice location
722 Yorklyn Rd
Suite 400
Hockessin, DE 19707-8718
Mailing address
722 Yorklyn Rd
Suite 400
Hockessin, DE 19707-8718
Phone (302) 235-2351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861554271 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 20, 2022 through Jul 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234310400000",
"number": "1861554271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 YORKLYN RD",
"address_2": "SUITE 400",
"city": "HOCKESSIN",
"state": "DE",
"postal_code": "197078718",
"telephone_number": "302-235-2351",
"fax_number": "302-235-2365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 YORKLYN RD",
"address_2": "SUITE 400",
"city": "HOCKESSIN",
"state": "DE",
"postal_code": "197078718",
"telephone_number": "302-235-2351",
"fax_number": "302-235-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "EUN",
"middle_name": "AE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2009-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "DE",
"license": "C10008813",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1861554271",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hockessin, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.