Individual provider Active NPI

Ivone Eun Kyung Kim, M.D.

  • Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1952506339
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT190520 Issued in PA
Practice address
3705 5TH Ave
Pittsburgh, PA 15213-2584
Phone
(412) 692-5325
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT190520 PA Primary

Addresses

Primary practice location

3705 5TH Ave
Pittsburgh, PA 15213-2584

Mailing address

5530 5TH Ave Apt B5
Pittsburgh, PA 15232-2334
Phone (240) 638-6691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190425002507 MD Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7911199500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT190520PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Pediatrics Past Accepting new patients
University of Pittsburgh Physicians Past Accepting new patients

Organizations & group practices 2

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952506339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 5TH AVE APT B5",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152322334",
            "telephone_number": "240-638-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 5TH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132584",
            "telephone_number": "412-692-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "IVONE",
        "middle_name": "EUN KYUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT190520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.