NPIMap

Individual provider Active NPI

Bu Jung Kim, MD

  • Family Medicine Physician
  • Mount Pocono, PA
National Provider Identifier
1891257648
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD478380 Issued in PA
Practice address
126 Market Way
Mount Pocono, PA 18344-1039
Phone
(570) 839-3633
Fax
(570) 839-6490
NPI assigned
Apr 2, 2019
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT219307 PA
Family Medicine Physician 207Q00000X MD478380 PA Primary

Addresses

Primary practice location

126 Market Way
Mount Pocono, PA 18344-1039

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220915001795 PA Practitioner - Family Practice 2668708256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

166 Hanover St
Suite 105
Wilkes Barre, PA 18702-3543
Phone (570) 808-6672

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic CurrentSince Sep 1, 2022 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

499 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-2161

126 Market Way
Mount Pocono, PA 18344
Phone (570) 839-3633

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

Interoperability endpoints

  • Direct secure messaging: bkim179028@direct.geisinger.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1891257648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MARKET WAY",
            "city": "MOUNT POCONO",
            "state": "PA",
            "postal_code": "183441039",
            "telephone_number": "570-839-3633",
            "fax_number": "570-839-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BU JUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT219307",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD478380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pocono, PA

Sources for this page

Verify at the official NPI Registry.