MIRIAM GRACE KIM D.O.
NPI 1891052171
Pediatrics - Pediatric Hematology-Oncology in Indianapolis, IN

Active since April 11, 2012PECOS EnrolledAccepts Medicare Assignment
705 RILEY HOSPITAL DR, ROC 4340, INDIANAPOLIS, IN 46202(317) 944-2143(317) 944-3107 Get Directions Write a Review

NPPES record last updated: February 14, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 8, 2020, Jan 8, 2020, Jun 26, 2018 and 1 more (4 updates tracked since 2017).

About Miriam Grace Kim D.o. NPPES

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

MIRIAM GRACE KIM D.O. (NPI 1891052171) is an individual pediatric hematology-oncology provider in Indianapolis, Indiana, licensed in Indiana (02005955A) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1891052171
Entity TypeIndividualFemale
Primary Taxonomy2080P0207X
Provider Legal NameMIRIAM GRACE KIMCredential: D.O.
Location Address705 RILEY HOSPITAL DR, ROC 4340Indianapolis, IN 46202-5109
Mailing AddressPo Box 719094Chicago, IL 60677-9318 · (317) 777-6435 · Fax (317) 777-6644
Fax(317) 944-3107
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateApril 11, 2012
Last NPPES UpdateFebruary 14, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 14, 2026
NPI 1891052171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
Licenses Licensed in IN · 02005955A Licensed in WI · 63854-21
Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

705 RILEY HOSPITAL DR, Indianapolis, IN 46202

Secondary Practice Locations 3

Location 1600 Highland AveMadison, WI 53792-0001 · Phone (608) 263-8556
Location 22525 Chicago AveMinneapolis, MN 55404-4518 · Phone (312) 752-8176
Location 3420 Delaware St SE, MCRB, Suite 660 MMC 366Minneapolis, MN 55455-0341 · Phone (612) 624-3113

Other Identifiers 1

Medicaid300036343IN

Accepted 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

Miriam Grace Kim D.o. 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 ID9638480882
PECOS Enrollment IDI20200415002021
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 20

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

Pediatrics (Pediatric Rheumatology)
705 RILEY HOSPITAL DR, RR 307
INDIANAPOLIS, IN 46202
Pediatrics (Pediatric Hematology-Oncology)
705 RILEY HOSPITAL DR, ROC 4340
INDIANAPOLIS, IN 46202
Pediatrics (Adolescent Medicine)
705 RILEY HOSPITAL DR, MSA 2
INDIANAPOLIS, IN 46202
Pediatrics
705 RILEY HOSPITAL DR, RI 1601
INDIANAPOLIS, IN 46202
Otolaryngology
705 RILEY HOSPITAL DR, SUITE 0860
INDIANAPOLIS, IN 46202
Pediatrics (Neonatal-Perinatal Medicine)
705 RILEY HOSPITAL DR, RR 208
INDIANAPOLIS, IN 46202
Pediatrics
705 RILEY HOSPITAL DR, STE 1721
INDIANAPOLIS, IN 46202
Audiologist (Assistive Technology Practitioner)
705 RILEY HOSPITAL DR, 0860
INDIANAPOLIS, IN 46202

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891052171, enumerated as an "individual" on April 11, 2012.

The provider is located at 705 RILEY HOSPITAL DR ROC 4340 INDIANAPOLIS, IN 46202 and the phone number is (317) 944-2143.

Pediatrics with taxonomy code 2080P0207X and a focus in Pediatric Hematology-Oncology.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.