Individual provider Active NPI

Chang Yong Kim, DPM

  • Podiatrist
  • Rockville, MD
National Provider Identifier
1902330400
Registry record updated Jun 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01780 Issued in MD
Practice address
4701 Randolph Rd
Rockville, MD 20852-2257
Phone
(240) 206-6274
Fax
(240) 599-4344
NPI assigned
Apr 12, 2017
Last updated
Jun 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01780 MD Primary
Podiatrist 213E00000X 0103301376 VA

Addresses

Primary practice location

4701 Randolph Rd
Rockville, MD 20852-2257

Mailing address

4701 Randolph Rd Ste 103
Rockville, MD 20852-2260
Phone (240) 206-6274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221201000076 DC Practitioner - Podiatry 9133535263 Reassigns benefits to 3 organizations
I20240627003171 VA Practitioner - Podiatry 9133535263 Reassigns benefits to 2 organizations
I20250416001342 MD Practitioner - Podiatry 9133535263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Forward Podiatry PCGroup PAC ID 3971995697, 29 clinicians

Practice addresses (Care Compare)

4701 Randolph Rd
Suite 103
Rockville, MD 20852-2260
Phone (216) 217-9322

7483 Candlewood Rd
Suite a
Hanover, MD 21076-3142
Phone (240) 206-6274

94 S Ave
Harrisonburg, VA 22801-2827
Phone (646) 921-0907

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
86.7
Promoting interoperability
100
Improvement activities
40
Cost
73.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue155
Removal or shaving of skin growth20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01780MDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 18, 2022 Accepting new patients
Eastern Podiatry PLLC Podiatrist CurrentSince May 27, 2024 Accepting new patients
Kim Podiatry LLC Podiatrist CurrentSince Jan 16, 2025 Accepting new patients
In Step Podiatry Center, LLC Podiatrist CurrentSince Apr 30, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
New Era Healthcare Inc. CurrentSince Feb 17, 2025 Accepting new patients
Eastern Podiatry PLLC Podiatrist CurrentSince May 27, 2024 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 18, 2022 Accepting new patients
Lewis J Sims DPM P.C. Podiatrist PastSince Dec 1, 2024 Accepting new patients
Foot Forward Podiatry, LLC Past Accepting new patients

Locations

2905 Mitchellville Rd
Ste 105
Bowie, MD 20716
Phone (240) 929-4844

7483 Candlewood Rd
Ste A
Hanover, MD 21076
Phone (240) 206-6274

4601 Presidents Dr
Lanham, MD 20706
Phone (240) 429-7652

4601 Presidents Dr
Ste 360
Lanham, MD 20706
Phone 3014300337101

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

4701 Randolph Rd
Ste 103
Rockville, MD 20852
Phone (216) 217-9322

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

1550 Wilson Blvd
Ste 105
Arlington, VA 22209
Phone (571) 487-8301

1550 Wilson Blvd
Ste 640
Arlington, VA 22209
Phone (703) 584-2040

10730 Main St
Fairfax, VA 22030
Phone (703) 491-9500

2922 Telestar Ct
Falls Church, VA 22042
Phone (703) 584-2040

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

1300 Enterprise Dr
Lynchburg, VA 24502
Phone (434) 200-1816

Interoperability endpoints

  • Direct secure messaging: 18cykim@cfaortho.emadirect.md
  • Direct secure messaging: chang.yong.kim.1@8061.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8061/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1902330400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 103",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522260",
            "telephone_number": "240-206-6274",
            "fax_number": "240-599-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522257",
            "telephone_number": "240-206-6274",
            "fax_number": "240-599-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHANG YONG",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01780",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.