Individual provider Active NPI

Kevin Kim, DO

  • Pulmonary Disease Physician
  • Lodi, NJ
National Provider Identifier
1942838370
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MB11663100 Issued in NJ
Practice address
160 Essex St Ste 103
Lodi, NJ 07644-2709
Phone
(551) 996-1370
Fax
(551) 996-1377
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 25MB11663100 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X NJ
Internal Medicine Physician 207R00000X 25MB11663100 NJ

Addresses

Primary practice location

160 Essex St Ste 103
Lodi, NJ 07644-2709

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20260420003460 NJ Practitioner - Pulmonary Disease 5294201828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Rowan University School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11663100NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Complex Care PC Internal Medicine Past Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Internal Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1942838370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ESSEX ST STE 103",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076442709",
            "telephone_number": "551-996-1370",
            "fax_number": "551-996-1377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEVIN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MB11663100",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB11663100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, NJ

Sources for this page

Verify at the official NPI Registry.