Individual provider Active NPI

Michael Kim, M.D.

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1881915551
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
Q0484 Issued in TX
Practice address
4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640
Phone
(210) 615-1187
Fax
(210) 614-2180
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 245134 MA
Anesthesiology Physician 207L00000X Q0484 TX Primary

Addresses

Primary practice location

4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640

Mailing address

PO Box 34717
San Antonio, TX 78265-4717
Phone (210) 615-1187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141022002439 TX Practitioner - Anesthesiology 9032342589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Boston University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen Anesthesia AssociatesGroup PAC ID 2264477140, 94 clinicians

Practice addresses (Care Compare)

4510 Medical Ctr Dr
Suite 211
McKinney, TX 75069-1602
Phone (469) 541-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0484TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Anesthesiology Group PLLC Anesthesiology CurrentSince Sep 25, 2023 Accepting new patients
Allen Anesthesia Associates CurrentSince Jul 6, 2023 Accepting new patients
Austin Anesthesiology Group, PLLC Anesthesiology CurrentSince Sep 25, 2023 Accepting new patients

Locations

906 W McDermott Dr
Allen, TX 75013
Phone (918) 812-4755

1105 Central Expy N
Ste 210
Allen, TX 75013
Phone (972) 747-4646

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

4401 Coit Rd
Ste 100
Frisco, TX 75035
Phone (214) 619-0120

4510 Medical Center Dr
Ste 211
McKinney, TX 75069
Phone (469) 541-1600

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

Organizations & group practices 3

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.

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1881915551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34717",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782654717",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR",
            "address_2": "SUITE 3100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295640",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "245134",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q0484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.