Individual provider Active NPI

Dooho Brian Kim, MD

  • Ophthalmology Physician
  • Dalton, GA
National Provider Identifier
1992844864
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
058533 Issued in GA
Practice address
1111 Professional Blvd
Dalton, GA 30720-2588
Phone
(705) 226-2020
Fax
(706) 217-2876
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 058533 GA Primary
Ophthalmology Physician 207W00000X MD026175 LA

Addresses

Primary practice location

1111 Professional Blvd
Dalton, GA 30720-2588

Mailing address

1111 Professional Blvd
Dalton, GA 30720-2588
Phone (705) 226-2020

Other identifiers 1

IdentifierTypeStateIssuer
587823919AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070705000469 GA Practitioner - Ophthalmology 3173623121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in New Orleans, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Eye Associates, Inc.Group PAC ID 4789677071, 7 clinicians

Practice addresses (Care Compare)

1111 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 226-2020

Hospital & facility affiliations

  • Hamilton Medical Center Hospital, Dalton, GA, CCN 110001

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery638
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD026175LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Eye Associates, Inc. Ophthalmology CurrentSince May 17, 2010 Accepting new patients
Professional Eye Associates, Inc. CurrentSince Mar 25, 2010 Accepting new patients
Professional Eye Associates, Inc. Past Accepting new patients
Professional Eye Associates, Inc. Past Accepting new patients
Professional Eye Associates, Inc. Ophthalmology Past Accepting new patients

Locations

101 Professional Ct SE
Calhoun, GA 30701
Phone (404) 783-5975

113 W Pine St
Chatsworth, GA 30705
Phone (706) 226-2020

1111 Professional Blvd
Dalton, GA 30720
Phone (404) 226-2232

2498 Lafayette Rd
Ft Oglethorpe, GA 30742
Phone (706) 866-2020

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1992844864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "705-226-2020",
            "fax_number": "706-217-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "705-226-2020",
            "fax_number": "706-217-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DOOHO",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "058533",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD026175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "587823919A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.