Ella Kim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA065029 Issued in PA

Practice address

3401 N Broad St
Philadelphia, PA 19140-5103

Phone

(152) 707-3133

Fax

(215) 707-2915

NPI assigned

Sep 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Temple Faculty Practice Plan Inc

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment NPD
• Temple Faculty Practice Plan Inc

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD
• Temple Faculty Practice Plan Inc

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1285116228
  NPD (past)
• Temple Faculty Practice Plan, Inc

  • Medical Oncology Physician
  • Philadelphia, PA
  • NPI 1417430166
  NPD (past)

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1962237792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST # 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "152-707-3133",
            "fax_number": "215-707-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donghyeon Harry Kim
• Doyoo Kim
• Du Ri Kim
• Edwin Kim, MD
• Eileen H Kim, MD
• Ellen Kim
• Ellen H Kim, MD
• Ellen J Kim, MD
• Esther J Kim, MD
• Esther M. Kim, M.D.

• Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.