John Minkyu Kim, DDS is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Ann Arbor, Michigan. His current practice location is
1500 E Medical Center Dr, Ann Arbor, Michigan. You can reach out to his office (for appointments etc.) via phone at
(734) 936-4000.
John Minkyu Kim is licensed to practice in Michigan (license number 2901601571) 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 1699039792.
Healthcare Provider's Profile
Full Name | John Minkyu Kim |
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Gender | Male |
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Speciality | Oral & Maxillofacial Surgery |
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Location | 1500 E Medical Center Dr, Ann Arbor, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699039792
- Provider Enumeration Date: 07/03/2012
- Last Update Date: 08/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 9537522313
- Enrollment ID: I20230825003008
Medical Identifiers
Medical identifiers for John Minkyu Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699039792 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | DT 2474 (Hawaii) | Secondary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | DT-2474 (Hawaii) | Secondary |
183500000X | Pharmacist | PH 2612 (Hawaii) | Secondary |
204E00000X | Oral & Maxillofacial Surgery | 2901601571 (Michigan) | 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. John Minkyu Kim allows following entities to bill medicare on his behalf.
Entity Name | Regents Of The University Of Michigan |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1467487694 PECOS PAC ID: 3779496856 Enrollment ID: O20031121000646 |
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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. John Minkyu 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 |
John Minkyu Kim, DDS 3621 S State St, Ann Arbor, MI 48108-1633 Ph: (734) 647-5299 | John Minkyu Kim, DDS 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 Ph: (734) 936-4000 |
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