TAEWAN KIM (NPI# 1992757421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992757421 |
| Entity Type | Individual |
| Full Name | TAEWAN KIM |
| Credential | MD |
| Practice Address |
140 W 6th St Ste Ll30 Oswego NY 13126-2564 |
| Mailing Address |
550 Harrison St Ste 330 Syracuse NY 13202-3188 |
| Practice Telephone | 3153495511 |
| Practice Fax Number | 3153495921 |
| Mailing Telephone | 3154641800 |
| Mailing Fax Number | 3154646252 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 220630 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | RAILROAD MEDICARE | P02005039 | 01 |
| NY | 02155824 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 505 Irving Ave, Ste 1249, Syracuse, NY 132101718 | 3154649852 | 3154649814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083264436 | Taewan John Kim | Dentist | 240 S 40th St, Philadelphia, PA 19104-6030 | 2019-09-18 |
| Street Address |
140 W 6TH ST STE LL30 |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126-2564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316419112 | Marilyn A Buckley | Nurse Practitioner | 140 W 6th St Ste Ll30, Oswego, NY 13126-2564 | 2018-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 1023651742 | Jessica Lynn Metzger | Physician Assistant | 300 Ny-104 Suite 1, Oswego, NY 13126 | 2019-10-25 |
| 1245887009 | Maureen Adams | Technician | 30 Stone Ridge Drive, Oswego, NY 13126 | 2019-08-26 |
| 1285128314 | Justin Raymond Beebe | Nurse Practitioner | 300 State Route 104 Ste 2, Oswego, NY 13126 | 2018-06-21 |
| 1801311220 | Lynne M Wallace | Registered Nurse | 29 Birch Lane 17b, Oswego, NY 13126 | 2017-08-07 |
| 1497203962 | Lindsay Cheslock | Local Education Agency (LEA) | 529 County Route 25, Oswego, NY 13126 | 2016-09-14 |
| 1942757919 | Aimee Devinny | Registered Nurse | 21 Twin Orchard Drive, Oswego, NY 13126 | 2016-09-07 |
| 1083160295 | Cameron Delmotte | Specialist | 159 West Frist Street, Oswego, NY 13126 | 2016-08-28 |
| 1508319187 | Samantha Thayer | Occupational Therapist | 159 West First Oswego St, Oswego, NY 13126 | 2016-07-29 |
| 1104279595 | Vikram Jala | Internal Medicine | 105 County Route 45a Ste 400, Oswego, NY 13126 | 2016-07-20 |
| Find all providers in zip 13126 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073852158 | James A. Sandrolini | Surgery | 245 Gray's Dr., Oswego, IL 60543 | 2013-02-08 |
| 1801945498 | Allison Duggan | Surgery | 110a W Utica St, Oswego, NY 13126-3052 | 2007-01-10 |
| 1588099451 | Jai P Singh | Surgery | 110 W 6th St, Oswego, NY 13126-2507 | 2013-09-10 |
| 1669619854 | Oswego Surgical Associates, LLC | Surgery | 38 Erie St, Oswego, NY 13126-3803 | 2009-01-10 |
| 1538372164 | James I Boles, M.d., P.C. | Surgery | 154 W 7th St, Oswego, NY 13126-2518 | 2007-05-08 |
| 1740391457 | James Irwin Boles | Surgery | 154 W 7th St, Oswego, NY 13126-2518 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321168 | Fernando Andres Angarita Celis | Surgery | Rosuell Park Comprehensive Cancer Center / Elm & Carlto, Streets / Scott Bieler Clinical Services Center 6th Fl, Buffalo, NY 14263 | 2020-09-23 |
| 1174147979 | North Shore-lij Medical Group At Huntington PC | Surgery | 2001 Marcus Ave Ste S50, New Hyde Park, NY 11042-1039 | 2020-06-08 |
| 1679194468 | Sowmya Sreekanth | Surgery | 124 Hutchinson Blvd, Mount Vernon, NY 10552-2510 | 2020-05-03 |
| 1558997015 | Health Quest Medcial Practice, PC | Surgery | 1240 Ulster Ave, Kingston, NY 12401-1517 | 2020-03-17 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1669014213 | Jason Euseph Copeland | Surgery | 665 Elm and Carlton Street Elm and Carlton Street, Buffalo, NY 14263-0001 | 2019-10-16 |
| 1023678984 | Core Surgical | Surgery | 133 E 58th St Ste 703, New York, NY 10022-1138 | 2019-06-13 |
| 1568923134 | Thompson Surgical Pllc | Surgery | 77 Alpine Way, South Huntington, NY 11746-4610 | 2019-03-27 |
| 1851863377 | Alice Chia-chi Wei | Surgery | 1275 York Ave Ste C-866a, New York, NY 10065-6007 | 2018-12-21 |
| Find all providers with the same taxonomy | ||||
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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.