Individual provider Active NPI

Eun Ha Kim, M.D.

  • Psychiatry Physician
  • Madison, WI
National Provider Identifier
1962793646
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
69293-20 Issued in WI
Practice address
1102 S Park St
Madison, WI 53715-1708
Phone
(608) 282-8270
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 69293 WI
Psychiatry Physician 2084P0800X 69293-20 WI Primary

Addresses

Primary practice location

1102 S Park St
Madison, WI 53715-1708

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ekim924422@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20190930002060 WI Practitioner - Psychiatry 8628388204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1102 S Park St
Madison, WI 53715-1714
Phone (608) 287-2770

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69293-20WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 1, 2019 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Oct 1, 2019 Accepting new patients

Locations

1102 S Park St
Madison, WI 53715
Phone (608) 263-3111

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

Interoperability endpoints

  • Direct secure messaging: ekim924422@direct.uwhealth.org

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1962793646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151708",
            "telephone_number": "608-282-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUN HA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "WI",
            "license": "69293",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "69293-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekim924422@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1102 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.