Michael Kim, - Medicare Nurse Practitioner in Chicago, IL

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Michael Kim, is a medicare enrolled "Nurse Practitioner - Family" in Chicago, Illinois. His current practice location is 3860 W Ogden Ave, Chicago, Illinois. You can reach out to his office (for appointments etc.) via phone at (872) 588-3000.

Michael Kim is licensed to practice in Illinois (license number 209023836) 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 1023609005.

Contact Information

Michael Kim,
3860 W Ogden Ave,
Chicago, IL 60623-2460
(872) 588-3000
Not Available

Map and Direction




Provider's Profile

Full NameMichael Kim
GenderMale
SpecialityNurse Practitioner - Family
Location3860 W Ogden Ave, Chicago, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1023609005
  • Provider Enumeration Date: 02/01/2021
  • Last Update Date: 01/12/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3274926225
  • Enrollment ID: I20220215001723

Medical Identifiers

Medical identifiers for Michael Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023609005NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 209023836 (Illinois)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. Michael Kim allows following entities to bill medicare on his behalf.
Entity NameLawndale Christian Health Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245289214
PECOS PAC ID: 2264336346
Enrollment ID: O20031120000728
Entity NameDatta Sambare M D S C
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780606566
PECOS PAC ID: 9234199845
Enrollment ID: O20041018000376

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. Michael 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 AddressPractice Location Address
Michael Kim,
3860 W Ogden Ave,
Chicago, IL 60623-2460

Ph: (872) 588-3000		Michael Kim,
3860 W Ogden Ave,
Chicago, IL 60623-2460

Ph: (872) 588-3000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.