Individual provider Active NPI

Eugene Kim, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1891967675
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
245778 Issued in MA
Practice address
330 Brookline Ave
Ya 204
Boston, MA 02215-5400
Phone
(216) 410-3909
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 57.013921 OH
Pediatric Anesthesiology Physician 207LP3000X 245778 MA
Anesthesiology Physician 207L00000X 245778 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Ya 204
Boston, MA 02215-5400

Mailing address

75 Saint Alphonsus St
Apt 1911
Roxbury Crossing, MA 02120-1676
Phone (216) 410-3909

Other practice location 1

41 Mall Rd
Burlington, MA 01805-5400
Phone (781) 744-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20120125000009 MA Practitioner - Anesthesiology 6406023902 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245778MAMDAnesthesiology Physician
57.013921OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Anesthesia Foundation Inc Anesthesiology CurrentSince Jan 1, 2012 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Nov 16, 2011 Accepting new patients
Lahey Clinic, Inc Current Accepting new patients
Lahey Clinic, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Anesthesiology CurrentSince Nov 16, 2011 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

330 Brookline Ave
#204
Boston, MA 02215
Phone (216) 410-3909

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

Interoperability endpoints

  • Direct secure messaging: ekim196026@direct.bilh.masshiway.net

Organizations & group practices 5

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1891967675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 SAINT ALPHONSUS ST",
            "address_2": "APT 1911",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021201676",
            "telephone_number": "216-410-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "YA 204",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "216-410-3909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018055400",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "57.013921",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MA",
            "license": "245778",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "245778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.