Individual provider Active NPI

Robert J Kim, MD

  • Clinical Cardiac Electrophysiology Physician
  • Jacksonville, FL
National Provider Identifier
1912013947
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME101790 Issued in FL
Practice address
655 W 8TH St
Ufjp Cardiology
Jacksonville, FL 32209
Phone
(904) 244-4198
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 062240 GA
Cardiovascular Disease Physician 207RC0000X ME101790 FL
Cardiovascular Disease Physician 207RC0000X 12499 NH
Clinical Cardiac Electrophysiology Physician 207RC0001X ME101790 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjp Cardiology
Jacksonville, FL 32209

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008

Other identifiers 4

IdentifierTypeStateIssuer
0002209-00MedicaidFL
620362047BMedicaidGA
620362047AMedicaidGA
620362047CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081110000557 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 5294894952 Reassigns benefits to 3 organizations
I20091209000417 GA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 5294894952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Tufts University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashchi Heart and Vascular Center PAGroup PAC ID 0941519979, 9 clinicians

Practice addresses (Care Compare)

306 Westside Dr
Douglas, GA 31533-3530
Phone (904) 222-6656

3900 University S Blvd a
Jacksonville, FL 32216-4391
Phone (904) 222-6656

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME101790FLMDCardiovascular Disease Physician
12499NHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Sep 30, 2009 Accepting new patients
University of Florida Jacksonville Physicians Inc Cardiovascular Disease CurrentSince Sep 1, 2008 Accepting new patients
Cardiology Interpreters Inc CurrentSince Apr 24, 2021 Accepting new patients
Ashchi Heart & Vascular Center PA Cardiovascular Disease CurrentSince May 1, 2019 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Sep 1, 2008 Accepting new patients
Bagnoli and Salah Partnership PastSince May 1, 2019 Accepting new patients

Locations

3900 University Blvd S
Ste A
Jacksonville, FL 32216
Phone (904) 222-6656

3900 University Blvd S
Jacksonville, FL 32216
Phone (904) 222-6656

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

2025 Indian Rocks Rd S
Largo, FL 33774
Phone (727) 581-9474

306 Westside Dr
Douglas, GA 31533
Phone (912) 383-7826

201 Lakeshore Pt
Ste B
Saint Marys, GA 31558
Phone (912) 729-6821

Interoperability endpoints

  • Direct secure messaging: robertkim@ahvcpa.allscriptsdirect.net

Organizations & group practices 6

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 1

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1912013947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP CARDIOLOGY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-244-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "062240",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME101790",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NH",
            "license": "12499",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME101790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002209-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620362047B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620362047A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620362047C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.