JAEYOUNG KIM MD NPI 1053016709

NPI Information

  • NPI: 1053016709
  • Provider Name: JAEYOUNG KIM, MD
  • Classification: Orthopaedic Surgery - 207XX0004X
  • Specialization: Foot and Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 55 FRUIT ST
    BOSTON, MA
    ZIP 02114
  • Phone: (617) 726-2000

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NPI Details

Jaeyoung Kim, MD is a foot and ankle surgery orthopaedic surgery in Boston, MA. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. Jaeyoung Kim, MD NPI is 1053016709. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

55 FRUIT ST
BOSTON, MA
ZIP 02114-696
Phone: (617) 726-2000

The NPI 1053016709 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 4/3/2023 and was last updated on 1/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207XX0004XOrthopaedic SurgeryFoot and Ankle Surgery3015846MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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