Edwin H. Kim, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

0101226427 Issued in VA

Practice address

8629 Sudley Rd
Suite 102
Manassas, VA 20110-4590

Phone

(703) 361-3030

Fax

(703) 361-2687

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

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.

• Singleton Associates PA

  • Diagnostic Radiology Physician
  • Shenandoah, TX
  • NPI 1538107875
  Medicare reassignment
• Clinical Radiologists Medical Imaging PA

  • Diagnostic Radiology Physician
  • Silver Spring, MD
  • NPI 1871503912
  NPD (past)
• Diagnostic Medical Imaging PA

  • Diagnostic Radiology Physician
  • Silver Spring, MD
  • NPI 1962412007
  NPD (past)
• Johns Hopkins Community Physicians, Inc

  dba JHCP - 195 Thomas Johnson Drive

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1770518003
  NPD (past)
• Monmouth Radiologists PA

  • Diagnostic Radiology Physician
  • Long Branch, NJ
  • NPI 1316008782
  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1912977034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8629 SUDLEY RD",
            "address_2": "SUITE 102",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104590",
            "telephone_number": "703-361-3030",
            "fax_number": "703-361-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 SUDLEY RD",
            "address_2": "SUITE 102",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104590",
            "telephone_number": "703-361-3030",
            "fax_number": "703-361-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDWIN",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101226427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10038383",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10038294",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "6688-0027",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10038341",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10029139",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10038316",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carley Kieffer, RBT
• Kellee S. Kietzer, LPTA
• Kristen Killngsworth
• Christina Kim
• Edward C Kim, MD
• Eugene H Kim, MD
• Ji Yeon Kim
• John Jungkyum Kim, M.D.
• Julian Cassia Kim
• Lauren Kim

• Diagnostic Radiology Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Diagnostic Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.