Individual provider Active NPI

Alice I Kim, MD

  • Infectious Disease Physician
  • Hillsborough, NJ
National Provider Identifier
1982661807
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
25MA11974700 Issued in NJ
Practice address
105 Raider Blvd Ste 101
Hillsborough, NJ 08844-1528
Phone
(908) 281-0221
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 35076161K OH
Infectious Disease Physician 207RI0200X 25MA11974700 NJ Primary

Addresses

Primary practice location

105 Raider Blvd Ste 101
Hillsborough, NJ 08844-1528

Mailing address

105 Raider Blvd Ste 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

Other identifiers 1

IdentifierTypeStateIssuer
2261065MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060929000041 OH Practitioner - Infectious DiseasePractitioner - Internal Medicine 7911902770 Reassigns benefits to 1 organization
I20231009000382 NJ Practitioner - Infectious Disease 7911902770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Northeastern Ohio University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 636-1768

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35076161KOHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Id Care LLC Infectious Disease CurrentSince Sep 18, 2023 Accepting new patients

Locations

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1982661807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD STE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD STE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALICE",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35076161K",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA11974700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2261065",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NJ

Sources for this page

Verify at the official NPI Registry.