SOO R KIM MD PC (NPI# 1730204421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730204421 |
| Entity Type | Organization |
| Organization Name | SOO R KIM MD PC |
| Practice Address |
29 West Oneida St Oswego NY 13126 |
| Practice Telephone | 3153435970 |
| Practice Fax Number | 3153433739 |
| Mailing Telephone | 3153435970 |
| Mailing Fax Number | 3153433739 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2013-04-08 |
| Authorized Official Name | MR. SOO R KIM (OWNER) |
| Authorized Official Telephone | 3153435970 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 149942 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CURRENT NPI# | 1851475958 | 01 | |
| NY | 00758076 | 05 |
| Street Address |
29 WEST ONEIDA ST |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033588686 | George Pearah | Internal Medicine | 408 Sudbury Circle, Oswego, IL 60543 | 2015-09-24 |
| 1841358645 | Ravi Seth | Internal Medicine | 11 4th Street, Suite F, Oswego, NY 13126 | 2006-12-05 |
| 1851475958 | Soo R. Kim | Internal Medicine | 29 W Oneida St, Oswego, NY 13126 | 2006-10-25 |
| 1003928953 | Padma Ram | Internal Medicine | 300 State Route 104, Suite 1, Oswego, NY 13126-2956 | 2006-08-31 |
| 1174639777 | Dennis P. Norfleet | Internal Medicine | 3187 State Route 48, Oswego, NY 13126 | 2006-08-23 |
| 1922115427 | Mario Magsino | Internal Medicine | Mary Walker Health Center Suny Oswego Bldg #10, Oswego, NY 13126 | 2006-08-23 |
| 1922012517 | Ravi Seth | Internal Medicine | 11 Fourth Streeet, Suite F Hillside Commons, Oswego, NY 13126-3009 | 2006-07-28 |
| 1447271259 | Carlos Oblena Dator | Internal Medicine | 90 W Utica St, Oswego, NY 13126-3048 | 2006-07-21 |
| 1346267291 | Carmen S Bautista Dator | Internal Medicine | 177 W 4th St, Oswego, NY 13126-3009 | 2006-07-16 |
| 1912275793 | Edith Senyumba | Internal Medicine | 10 George St, Oswego, NY 13126-3276 | 2011-12-07 |
| Find all providers in OSWEGO | ||||
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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.