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DR. PETER KIM MD
NPI 1669754925
Surgery - Pediatric Surgery in Providence, RI

Active since September 13, 2011PECOS Enrolled
2 DUDLEY ST STE 190, PROVIDENCE, RI 02905(401) 553-8341(401) 868-2319 Get Directions Write a Review

NPPES record last updated: February 5, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 5, 2020, Sep 26, 2019 (2 updates tracked since 2019).

About Dr. Peter Kim Md NPPES

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

DR. PETER KIM MD (NPI 1669754925) is an individual pediatric surgery provider in Providence, Rhode Island, licensed in Rhode Island (MD16869) and active in the NPI registry since September 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669754925
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameDR. PETER KIMCredential: MD
Location Address2 DUDLEY ST STE 190Providence, RI 02905-3248
Mailing AddressPo Box 16149Rumford, RI 02916-0697 · (401) 453-9625 · Fax (401) 435-7069
Phone(401) 553-8341
Fax(401) 868-2319
Sole ProprietorNo
Enumeration DateSeptember 13, 2011
Last NPPES UpdateFebruary 5, 20202 updates tracked since enumeration
✔ NPI 1669754925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in RI · MD16869
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedSurgeryTaxonomy 208600000X · License MD039738 (DC)
2 DUDLEY ST STE 190, Providence, RI 02905
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Peter Kim Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 9

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

KRISTEN LEIGH KLIMM PA-C
Physician Assistant (Surgical)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 421-1939
KELSEY VAN HOUSEN PA-C
Physician Assistant
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 421-1939
CARL-CHRISTIAN ANDREW JACKSON MD
Surgery (Pediatric Surgery)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 228-0623
ARTUR CHERNOGUZ MD
Surgery (Pediatric Surgery)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 228-0576
JOSHUA NATHANAEL HONEYMAN M.D.
Surgery (Pediatric Surgery)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 228-0576
DR. JULIE MONTEAGUDO M.D.
Surgery (Pediatric Surgery)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 228-0580
MAKAYLA LOURENCO NP
Nurse Practitioner (Pediatrics)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 421-1939
DR. SAMANTHA LYNN AHLE M.D.
Surgery (Pediatric Surgery)
2 DUDLEY ST STE 190
PROVIDENCE, RI 02905
Providence County (401) 421-1939

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 Peter Kim's NPI number?

The NPI number for Peter Kim is 1669754925. It was assigned to this individual provider in the NPPES registry on September 13, 2011.

Where is Peter Kim located?

Peter Kim practices at 2 Dudley St Ste 190, Providence, RI 02905. The listed phone number is (401) 553-8341.

What is Peter Kim's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Peter Kim enrolled in Medicare?

Yes. Peter Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Peter Kim was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.