DR. MICHAEL D KIM (NPI# 1427002179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427002179 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL D KIM |
| Credential | D.O. |
| Practice Address |
802 Jefferson Ave 5th Floor Scranton PA 18510-1038 |
| Practice Telephone | 5703481118 |
| Practice Fax Number | 5703481109 |
| Mailing Telephone | 5703481118 |
| Mailing Fax Number | 5703481109 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2014-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
OS012236 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346627742 | Michael Kim | Acupuncturist | 22337 65th Ave, 1st Floor, Oakland Gardens, NY 11364-2313 | 2015-05-05 |
| 1174945273 | Michael Jong-gyu Kim | Dentist | 27382 Calle Arroyo, San Juan Capistrano, CA 92675-2746 | 2014-01-09 |
| 1639441934 | Michael Tonkyu Kim | Dentist | 2880 Old Dixwell Ave., Hamden, CT 06518 | 2012-02-01 |
| 1336476373 | Michael Hwangsuk Kim | Dentist | 12865 Main St, #201, Garden Grove, CA 92840-8205 | 2009-11-12 |
| 1861658486 | Michael Kim | Anesthesiology | 3757 Camino Cermenon, Yorba Linda, CA 92886-6213 | 2008-08-03 |
| 1609076512 | Michael K Kim | Chiropractor | 8748 Garden Grove Blvd, Garden Grove, CA 92844-1251 | 2007-07-19 |
| 1164546313 | Michael Sukkyu Kim | Optometrist | 1000 Seward Meridian Highway, Wasilla, AK 99654 | 2007-03-16 |
| 1689720468 | Michael M Kim | Otolaryngology | 2525 Nw Lovejoy St Ste 402, Portland, OR 97210-2865 | 2007-01-26 |
| 1093870198 | Michael S. Kim | Dentist | 2800 W Warner Ave, Suite G, Santa Ana, CA 92704-5466 | 2006-12-27 |
| 1295810554 | Michael Ethan Kim | Dentist | 5322 Francis Lewis Blvd, 2nd Floor, Oakland Gardens, NY 11364-1633 | 2006-10-26 |
| Street Address |
802 JEFFERSON AVE 5TH FLOOR |
| City | SCRANTON |
| State | PA |
| Zip Code | 18510-1038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315085 | John E Prior | Internal Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2005-06-08 |
| 1730559881 | Jennifer Balinas | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2015-10-01 |
| 1578932414 | Michael Eugene Boyd | Nurse Practitioner | 802 Jefferson Ave, Mcauley Bldg 4th Fl, Scranton, PA 18510-1038 | 2015-09-22 |
| 1720461866 | Daniel Reese Shust | Family Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2015-07-07 |
| 1043498512 | Kenneth H. Rudolph, M.d. | Internal Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2008-02-06 |
| 1801927694 | Pulmonary and Critical Care Specialists of Pennsylvania PC | Internal Medicine | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2007-03-07 |
| 1164590071 | Alexa Lee Beretski | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-11-30 |
| 1265522015 | Susan Bennett | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-10-13 |
| 1831289693 | Amy Ferranti | Physician Assistant | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-10-13 |
| 1346269578 | American Home Care Supply Company, Inc. | Durable Medical Equipment & Medical Supplies | 802 Jefferson Ave, Scranton, PA 18510-1038 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427432335 | Marla Osborne Dempsey | Family Medicine | 1141 Clay Ave Ste 1, Dunmore, PA 18510 | 2015-07-10 |
| 1669620043 | Mary Jane Miskovsky | Nurse Practitioner | 800 Linden Street, University of Scranton Student Health Service, Scranton, PA 18510 | 2008-08-28 |
| 1427174739 | Cheryl Friedman | Registered Nurse | 1710 Mulberry Street, Scranton, PA 18510 | 2007-03-21 |
| 1619092970 | Susan Rudalavage | Dietitian, Registered | 640 Madison Avenue, Scranton, PA 18510 | 2007-03-19 |
| 1851469738 | Lackawanna Surgery Center LLC | Clinic/Center | 415 Adams Avenue, Scranton, PA 18510 | 2006-12-01 |
| 1679666150 | Nicholas M. Rocco | Nurse Anesthetist, Certified Registered | 700 Quincy Ave., Scranton, PA 18510 | 2006-10-02 |
| 1710927587 | Care Plus Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Jefferson Ave, Scranton, PA 18510 | 2006-06-08 |
| 1619934189 | James M Haggerty | Podiatrist | 521 Ash Street, Dunmore, PA 18510 | 2006-04-28 |
| 1962461145 | Kevin G Madden | Psychiatry & Neurology | 802 Jefferson Avenue, Scranton, PA 18510 | 2006-03-17 |
| 1720058795 | Mark Trently | Nurse Anesthetist, Certified Registered | 1822 Jmulberry St, Scranton, PA 18510 | 2006-01-24 |
| Find all providers in zip 18510 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447602255 | New Freedom Behavioral Health, LLC | Psychiatry & Neurology | 72 Hillside Ln, Fallsington, PA 19054-1133 | 2016-07-05 |
| 1669840930 | Recovery Pathways | Psychiatry & Neurology | 396 Locust Ave, Washington, PA 15301-3357 | 2015-09-03 |
| 1083820377 | Reading Hospital | Psychiatry & Neurology | Sharp Avenue & Frances Street, Laureldale, PA 19605 | 2007-05-15 |
| 1447384193 | Frederick Rhode Stoddard II | Psychiatry & Neurology | 349 Lancaster Ave Ste 206, Haverford, PA 19041 | 2007-03-15 |
| 1366518847 | Kimberly Toland Jones | Psychiatry & Neurology | 850 W Lancaster Ave, 2nd Fl Lower Merion Counseling Services, Bryn Mawr, PA 19010-3220 | 2006-11-28 |
| 1578649299 | Roy Christopher Monsour | Psychiatry & Neurology | 119 Dakota Ln, Ligonier, PA 15658-3617 | 2006-10-27 |
| 1548203425 | James Jay Nocks | Psychiatry & Neurology | 920 E Baltimore Pike, Kennett Square, PA 19348-1800 | 2006-06-14 |
| 1134789662 | 2 Crows LLC | Psychiatry & Neurology | 722 E Butler Pike, Ambler, PA 19002-2310 | 2019-06-17 |
| 1669901658 | Gnh Bhimasani Inc | Psychiatry & Neurology | 321 Lois Ln, State College, PA 16801-2561 | 2017-06-05 |
| 1497299085 | Quantum Health Practice, LLC | Psychiatry & Neurology | 505 York Rd, Suite 7a, Jenkintown, PA 19046-2136 | 2016-12-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.