Chang Soo Kim, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

048229 Issued in CT

Practice address

999 Summer St
Stamford, CT 06905-5546

Phone

(203) 920-1444

Fax

(866) 920-5178

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1891719860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 SUMMER ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055546",
            "telephone_number": "203-920-1444",
            "fax_number": "866-920-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SUMMER ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055546",
            "telephone_number": "203-920-1444",
            "fax_number": "866-920-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHANG SOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA07582400",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "048229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bozena Joanna Kierski, DDS
• Anitha Kilari, M.D
• Andrew Killen, MD
• Jeffrey Kilstein
• Bo la Kim, APRN
• CHI-Son Kim, MD
• DO Yoon Kim, D.D.S
• Jae Min Kim, APRN, PMHNP-C
• Jihyun Kim, PHARM.D., RPH
• Katelyn Kim

• Plastic Surgery Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Plastic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.