Peter Kim (NPI# 1417925900, PAC ID# 9537139522) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1417925900 |
| PAC ID by PECOS | 9537139522 |
| Professional Enrollment ID | I20051219000844 |
| Full Name | Peter Kim |
| Address |
4208 Evergreen Ln Suite 222 Annandale VA 22003-3251 |
| Gender | M |
| Credential | MD |
| Graduation Year | 2000 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490040 | INOVA ALEXANDRIA HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4208 Evergreen Ln, Suite 222, Annandale, VA 22003-3251 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
4208 EVERGREEN LN SUITE 222 |
| City | ANNANDALE |
| State | VA |
| Zip | 22003-3251 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Divya C Sridharan | Obstetrics/gynecology | Annandale Ob Gyn | 4208 Evergreen Ln, Suite 213, Annandale, VA 22003-3254 |
| Elham Waheeda Altaf | Obstetrics/gynecology | Annandale Ob Gyn | 4208 Evergreen Ln, Suite 213, Annandale, VA 22003-3254 |
| Anna Khanh Le | Obstetrics/gynecology | Annandale Ob Gyn | 4208 Evergreen Ln, Suite 213, Annandale, VA 22003-3254 |
| Khank Diem Le | Internal Medicine | 4208 Evergreen Ln, Suite 214, Annandale, VA 22003-3254 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Cassidy | Orthopedic Surgery | 3301 Woodburn Rd, Suite 208, Annandale, VA 22003-1200 | |
| Samuel Hawken | Orthopedic Surgery | Fairfax Orthopaedics, Pllc | 3301 Woodburn Rd, Suite 208, Annandale, VA 22003-1200 |
| Colleen A Kennedy | Orthopedic Surgery | Fairfax Orthopaedics, Pllc | 3301 Woodburn Rd, Suite 208, Annandale, VA 22003-1200 |
| John K Wilson | Psychiatry | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Sean C Graham | Clinical Social Worker | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Susan D Campbell | Clinical Nurse Specialist | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Megan M Oconnor | Clinical Social Worker | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Navdeep K Dhaliwal | Psychiatry | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Anna G Davis | Clinical Social Worker | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Susan M Dempsey Lyle | Clinical Nurse Specialist | Mental Health Services | 3300 Woodburn Rd, Annandale, VA 22003-1202 |
| Find all physicians in zip 22003 | |||
| City | ANNANDALE |
| Zip Code | 22003 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ANNANDALE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Peter Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.