Individual provider Active NPI

Miriam Grace Kim, D.O.

  • Pediatric Hematology & Oncology Physician
  • Indianapolis, IN
National Provider Identifier
1891052171
Registry record updated Feb 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
02005955A Issued in IN
Practice address
705 Riley Hospital Dr
Roc 4340
Indianapolis, IN 46202-5109
Phone
(317) 944-2143
Fax
(317) 944-3107
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 63854-21 WI
Pediatric Hematology & Oncology Physician 2080P0207X 02005955A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Roc 4340
Indianapolis, IN 46202-5109

Mailing address

PO Box 719094
Chicago, IL 60677-9318
Phone (317) 777-6435

Other practice location 1

420 Delaware St SE
MCRB, Suite 660 MMC 366
Minneapolis, MN 55455-0341
Phone (612) 624-3113

Other practice location 2

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (312) 752-8176

Other practice location 3

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-8556

Other identifiers 1

IdentifierTypeStateIssuer
300036343MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200415002021 IN Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 9638480882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Pediatric Associates IncGroup PAC ID 2163326794, 100 clinicians
Iu Health Medical Group Riley Specialists LLCGroup PAC ID 9638669815, 285 clinicians

Practice addresses (Care Compare)

705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone (317) 944-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02005955AINMDPediatric Hematology & Oncology Physician
63854-21WIMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. CurrentSince May 1, 2020 Accepting new patients
Iu Health Medical Group Riley Specialists, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

705 Riley Hospital Dr
#4340
Indianapolis, IN 46202
Phone (317) 944-2143

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

Interoperability endpoints

  • Direct secure messaging: mkim5@direct.iuhealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771027200000",
    "number": "1891052171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779318",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "ROC 4340",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-2143",
            "fax_number": "317-944-3107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_2": "MCRB, Suite 660 MMC 366",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-624-3113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "312-752-8176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-263-8556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIRIAM",
        "middle_name": "GRACE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2026-02-14",
        "certification_date": "2026-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WI",
            "license": "63854-21",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IN",
            "license": "02005955A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300036343",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.