JAE K KIM M.D. NPI 1316981491
Anesthesiology in Canton, IL

Individual Male Anesthesiology PECOS Enrolled

About JAE K KIM M.D.

Jae Kim is an anesthesiologist established in Canton, Illinois and his medical specialization is Anesthesiology. The NPI number of Jae Kim is 1316981491 and was assigned on June 2006. The practitioner's primary taxonomy code is 207L00000X with license number 036056328 (IL). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1316981491
Provider Name JAE K KIM M.D.
Provider Location Address210 W WALNUT ST CANTON, IL 61520
Provider Mailing Address7309 N KNOXVILLE AVE SUITE 200 PEORIA, IL 61614
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Enumeration Date06-16-2006
Last Update Date05-04-2015

An anesthesiologist like Jae K Kim M.d. manages the care of surgical patients and pain relief through drug administration that reduces or eliminates pain during an operation, medical procedure or during labor and delivery of babies. During surgical procedures anesthesiologists are responsible for adjusting the amount of anesthetic, monitoring the patient's heart rate, body temperature, blood pressure and breathing.Jae Kim is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices..

Jae Kim is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.



Primary Taxonomy

Taxonomy Code207L00000X
ClassificationAnesthesiology
TypeAllopathic & Osteopathic Physicians
License No.036056328
License StateIL
Taxonomy DescriptionAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

Business Address

JAE K KIM M.D.
210 W WALNUT ST
CANTON, IL
ZIP 61520
Phone: (309) 647-5240
Fax: (309) 647-5104

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Mailing Address

JAE K KIM M.D.
7309 N KNOXVILLE AVE
SUITE 200
PEORIA, IL
ZIP 61614
Phone: (309) 691-6225
Fax: (309) 691-7635


PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
320060699OTHER (01)ILEIN
036056328MEDICAID (05)IL
P00945642OTHER (01)ILRAILROAD MEDICARE PTAN
IL2999MEDICARE PIN (08)IL
C39993MEDICARE UPIN (02)IL

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1316981491
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
23261882418
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 2 + 6 + 1 + 8 + 8 + 2 + 4 + 1 + 8 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1316981491 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1932152402 MUHAMMAD A ZAHEER M.D.
Individual
Radiology (Diagnostic Radiology)210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1972535607CANTON RADIOLOGY SERVICES, S.C.
Organization
Radiology (Diagnostic Radiology)210 W WALNUT ST
CANTON, IL 61520
(877) 852-4669
1346319001 ANGELA J HOLTHAUS CRNA
Individual
Nurse Anesthetist, Certified Registered210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1053480707 GERRI DELOST CRNA
Individual
Nurse Anesthetist, Certified Registered210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1003013038 DELLA EETEN CRNA
Individual
Nurse Anesthetist, Certified Registered210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1437448578 SANDRA ANNE HAWS MS, RD, LDN
Individual
Dietitian, Registered210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1306884622 RONALD CHAMPAGNE M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1609111988 WILLIAM SEVERT PT
Individual
Physical Therapist210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1588890214 TROY GREEN CRNA
Individual
Nurse Anesthetist, Certified Registered210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1740450998GRAHAM HOSPITAL ASSOCIATION
Organization
General Acute Care Hospital (Rural)210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1710928627JAE KIM, M.D.
Organization
Anesthesiology210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1417312232 DANIELLE MARIANNA SAUSAMAN RDN, LD
Individual
Dietitian, Registered210 W WALNUT ST GRAHAM HOSPITAL FOOD AND NUTRITION SERVICES
CANTON, IL 61520
(309) 647-5240
1790143683MIDWEST MOBILE ANESTHESIA CONSULTANTS, SC
Organization
Anesthesiology210 W WALNUT ST
CANTON, IL 61520
(309) 692-6572
1497723084 KEITH HARVEY IFFT M.D.
Individual
Anesthesiology210 W WALNUT ST
CANTON, IL 61520
(309) 360-2600
1487174744 JOSHUA J WILKINSON ACNP-AG
Individual
Nurse Practitioner (Acute Care)210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1780692087GRAHAM HOSPITAL ASSOCIATION
Organization
General Acute Care Hospital (Rural)210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1134236748GRAHAM HOSPITAL ASSOCIATION
Organization
Skilled Nursing Facility210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1750749826 SHAWN MICHAEL WYNN
Individual
Nurse Anesthetist, Certified Registered210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240
1124482252 RYAN DEUSHANE CRNA
Individual
Nurse Anesthetist, Certified Registered210 W WALNUT ST
CANTON, IL 61520
(309) 339-8414
1235699893 CHRISTINA WILLEY OT
Individual
Occupational Therapist210 W WALNUT ST
CANTON, IL 61520
(309) 647-5240

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Jae K Kim M.d. is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.