DR. JAEKEUN KIM (NPI# 1942715180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942715180 |
| Entity Type | Individual |
| Full Name | DR. JAEKEUN KIM |
| Other Name | DR. JAE KEUN KIM |
| Credential | MD, PHD, FACS |
| Practice Address |
41 Mall Rd Burlington MA 01805-0001 |
| Mailing Address |
101 Monmouth St Apt 414 Brookline MA 02446-5612 |
| Practice Telephone | 6179353261 |
| Mailing Telephone | 6179353261 |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2020-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204F00000X | Transplant Surgery | 283842 | MA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 273758 | MA | Student, Health Care |
| Street Address |
41 MALL RD |
| City | BURLINGTON |
| State | MA |
| Zip Code | 01805-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588923 | Gene Wong | Radiology | 41 Mall Rd, Burlington, MA 01805 | 2005-06-15 |
| 1689289977 | Justin Li | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-09-13 |
| 1235743741 | Rebecca C Mccarthy | Registered Nurse | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-09-02 |
| 1730791419 | Jason Lefkowitz | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-08-23 |
| 1235749185 | Jing Lun James Xu | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-08-05 |
| 1841808482 | Evgeny Romanov | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-07-20 |
| 1780201319 | Nicole Emily Arsenault | Nurse Practitioner | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-30 |
| 1841817590 | Joseph Clinton Mccabe | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-29 |
| 1730706508 | Hina Bhat | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-28 |
| 1902423734 | Jonathan Tong Xu | Student in an Organized Health Care Education/Training Program | 41 Mall Rd, Burlington, MA 01805-0001 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867909 | Natalie Teresa Dal'bo | Student in an Organized Health Care Education/Training Program | 41 Mall Road Office of Graduate Medical Education, Burlington, MA 01805 | 2018-07-11 |
| 1043710791 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Institute of Urology, Beverly, 41 Mall Rd., Burlington, MA 01805 | 2018-02-20 |
| 1902240872 | Lloyd Jones Jr. | Student in an Organized Health Care Education/Training Program | 41 Mall Rd Department of Plastic Surgery, Burlington, MA 01805 | 2013-04-23 |
| 1508020470 | Russell Andrew Baur | Internal Medicine | Lahey Clinic Inc., 41 Mall Road, Burlington, MA 01805 | 2008-07-10 |
| 1356491237 | Jacob Magee Sands | Internal Medicine | 41 Burlington Mall Rd., Lahey Clinic, Burlington, MA 01805 | 2007-01-11 |
| 1588757108 | Richard Alan Wold | Nurse Anesthetist, Certified Registered | Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-10-02 |
| 1841302387 | David M. Venesy | Internal Medicine | Lahey Clinic Cardiology -5 E, 41 Mall Road, Burlington, MA 01805 | 2006-08-31 |
| 1790750354 | Cara J. Foss | Nurse Practitioner | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-02-17 |
| 1750376380 | Darryl D Esakof | Internal Medicine | 41 Mall Road, Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805 | 2005-09-20 |
| 1225022155 | Laura Saluja | Internal Medicine | Lahey Clinic - General Internal Medicine, 41 Mall Road, Burlington, MA 01805 | 2005-09-07 |
| Find all providers in zip 01805 | ||||
| Taxonomy Code | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831139906 | James Scarboro Bowman IIi | Transplant Surgery | 2425 Lacy St, Burlington, NC 27215 | 2006-06-07 |
| 1386887818 | Jaime Pineda | Transplant Surgery | 111 Colchester Ave., Uvm Medical Center - Surgery/transplant, Burlington, VT 05401 | 2009-04-14 |
| 1790903524 | Caroline Simon | Transplant Surgery | 41 Mall Rd, Lahey Hospital and Medical Center, Burlington, MA 01805-0001 | 2007-04-24 |
| 1942428784 | Yee Cheah | Transplant Surgery | 41 Mall Rd, Lahey Hospital and Medical Center, Burlington, MA 01805-0001 | 2007-04-24 |
| 1093839789 | Bartholomew John Kane IIi | Transplant Surgery | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2007-03-19 |
| 1679581300 | Peter Panagiotis Metrakos | Transplant Surgery | 1 S Prospect St, Uhc Campus, Renal/transplant - 4th Fl, Burlington, VT 05401-3456 | 2006-08-05 |
| 1659309615 | University of Vermont Medical Center Inc | Transplant Surgery | 111 Colchester Ave, Burlington, VT 05401-1473 | 2006-06-29 |
| 1497793277 | Khalid Khwaja | Transplant Surgery | Lahey Clinic 41 Mall Rd, 4 West, Burlington, MA 01805-0001 | 2006-06-03 |
| 1518947860 | Roger Jenkins | Transplant Surgery | 41 Mall Rd, Lahey Clinic, Inc., Burlington, MA 01805-0001 | 2006-01-20 |
| 1245210517 | William Lewis | Transplant Surgery | 41 Mall Rd, Burlington, MA 01805-0001 | 2006-01-20 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 01805 |
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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.