Eileen E Kim, PA-C

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

PA9111629 Issued in FL

Practice address

5117 Fiorella LN
Sanford, FL 32771-5449

Phone

(407) 489-0800

NPI assigned

Oct 25, 2018

Sex

Female

Sole proprietor

Yes

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gastroenterology Associates of Southwest Florida LLCGroup PAC ID 8628960937, 62 clinicians

Gastro MD Florida, LLCGroup PAC ID 2264432558, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072
• Central Florida Lake Monroe Hospital Hospital, Sanford, FL, CCN 100161

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: eileen.kim@gog.eclinicaldirectplus.com

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.

• Gastroenterology Associates of Southwest Florida LLC

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1154304087

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Gastro MD Florida, LLC

  • Gastroenterology Physician
  • Orange City, FL
  • NPI 1821167230
  Medicare reassignment Care Compare group
• Associates in Digestive Health LLC

  • Gastroenterology Physician
  • Cape Coral, FL
  • NPI 1790868099

  Single Specialty

  NPD

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

• Central Florida Regional Hospital, Inc

  dba HCA Florida Lake Monroe Hospital

  • General Acute Care Hospital
  • Sanford, FL
  • NPI 1285681908
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  dba AdventHealth Fish Memorial

  • General Acute Care Hospital
  • Orange City, FL
  • NPI 1700978558
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  dba Adventhealth Medical Group

  • Internal Medicine Physician
  • Orange City, FL
  • NPI 1902095078

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1912474156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5117 FIORELLA LN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715449",
            "telephone_number": "407-489-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5117 FIORELLA LN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715449",
            "telephone_number": "407-489-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EILEEN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111629",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "PA9111629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Kelly, ARNP
• Katherine Elizabeth Kersjes
• Kids House of Seminole
• Kids House of Seminole, Inc.
• Kim-S Acupuncture Clinic Inc. (Sage Wellness Center)
• Jeffrey Kim, DPT
• Jin Ho Kim, DOM, AP, LAC, PD.D.
• Kendrick Sangyeop Kim
• Diane Kimball
• Kimberly Nelson Kent PHD LLC

• Gastroenterology Physician in Sanford, FL
• Providers in Sanford, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.