Dr Peter Kim, MD in Providence, RI

Dr Peter Kim, MD is a medicare enrolled "Surgery - Pediatric Surgery" physician in Providence, Rhode Island. His current practice location is 2 Dudley St Ste 190, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 553-8341.

Dr Peter Kim is licensed to practice in Rhode Island (license number MD16869) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1669754925.

Contact Information

	Dr Peter Kim, MD
	2 Dudley St Ste 190, Providence, RI 02905-3248
	(401) 553-8341
	(401) 868-2319

Map and Direction

Physician's Profile

Full Name	Dr Peter Kim
Gender	Male
Speciality	Surgery - Pediatric Surgery
Location	2 Dudley St Ste 190, Providence, Rhode Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669754925
Provider Enumeration Date: 09/13/2011
Last Update Date: 02/05/2020

Medicare PECOS Information:

PECOS PAC ID: 8527233139
Enrollment ID: I20240325003225

Medical Identifiers

Medical identifiers for Dr Peter Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669754925	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	MD039738 (District Of Columbia)	Secondary
2086S0120X	Surgery - Pediatric Surgery	MD16869 (Rhode Island)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Peter Kim allows following entities to bill medicare on his behalf.

Entity Name	Kaleida Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639209596 PECOS PAC ID: 7810805280 Enrollment ID: O20031105000212

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Peter Kim is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Peter Kim, MD Po Box 16149, Rumford, RI 02916-0697 Ph: (401) 453-9625	Dr Peter Kim, MD 2 Dudley St Ste 190, Providence, RI 02905-3248 Ph: (401) 553-8341

Reviews and Comments

Surgery Doctors in Providence, RI

Aileen Hsueh, Surgery Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8450 Fax: 401-444-5088
Liudmila Muraveika, Surgery Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180 Fax: 401-444-6681
Todd S Stafford, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 195 Collyer St Ste 302, Providence, RI 02904 Phone: 401-228-0633 Fax: 401-793-5171
Dr. Robert Ira Wolf, MD Surgery Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180
Abigail Case, MD Surgery Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180
Dr. Carl Winkler, MD Surgery Medicare: Medicare Enrolled Practice Location: 825 Chalkstone Ave, Providence, RI 02908 Phone: 212-523-4000
Edward J. Marcaccio Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2 Dudley St, Suite 470, Providence, RI 02905 Phone: 401-553-8318 Fax: 401-868-2307

Dr Peter Kim, MD - Medicare Surgery in Providence, RI