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MARY T KIM M.D.
NPI 1033192828
Surgery - Plastic and Reconstructive Surgery in Shreveport, LA

Active since November 25, 2005PECOS EnrolledAccepts Medicare Assignment
1501 KINGS HWY, SHREVEPORT, LA 71103(318) 675-6154 Get Directions Write a Review

NPPES record last updated: May 18, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mary T Kim M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY T KIM M.D. (NPI 1033192828) is an individual plastic and reconstructive surgery provider in Shreveport, Louisiana, licensed in Louisiana (MD200563) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Willis Knighton Medical Center, and is a graduate of Tufts University School Of Medicine (1997).

NPPES Registry Identity

NPI1033192828
Entity TypeIndividualFemale
Primary Taxonomy2086S0122X
Provider Legal NameMARY T KIMCredential: M.D.
Location Address1501 KINGS HWYShreveport, LA 71103-4228
Mailing Address1501 Kings HwyShreveport, LA 71103-4228 · (318) 675-6154
Phone(318) 675-6154
Sole ProprietorYes
Medical School CMSTufts University School Of MedicineGraduated 1997
Enumeration DateNovember 25, 2005
Last NPPES UpdateMay 18, 2009
✔ NPI 1033192828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in LA · MD200563
Definition
A surgeon who specializes in plastic and reconstructive surgery.
1501 KINGS HWY, Shreveport, LA 71103
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Other Identifiers 3

Medicare PIN4K020LA
Medicare UPINI48330LA
Medicaid1581518LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary T Kim M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618991316
PECOS Enrollment IDI20060120000623
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
23 services23 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Willis Knighton Medical Center

Acute Care Hospitals · Shreveport, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190111
Location2600 Greenwood RoadShreveport, LA 71103 · Caddo County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HS LOUISIANA, LLC
General Practice
1501 KINGS HWY, SUITE 5-303
SHREVEPORT, LA 71103
Caddo Parish (904) 834-2679
MUNIRA DAWITH MD
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY, PSYCHIATRY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-6619
MUHAMMAD AYUB
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0434
SEFI AHMED JAWADI
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0505
LUKE MUIZNIEKS
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-1574
KRISTIN BEMBENICK
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-5300
CHRISTIAN SCOTT BAKER MD
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-5053
BRYCE MILLER DO
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0434

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Kim's NPI number?

The NPI number for Mary Kim is 1033192828. It was assigned to this individual provider in the NPPES registry on November 25, 2005.

Where is Mary Kim located?

Mary Kim practices at 1501 Kings Hwy, Shreveport, LA 71103. The listed phone number is (318) 675-6154.

What is Mary Kim's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Mary Kim enrolled in Medicare?

Yes. Mary Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Kim accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 2 other insurers list Mary Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mary Kim affiliated with any hospitals?

According to CMS data, Mary Kim is affiliated with Willis Knighton Medical Center.

When was this NPI record last updated?

The NPPES record for Mary Kim was last updated on May 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.