STANLEY T KIM (M.D.) – Vascular & Interventional Radiology Physician, NPI 1790779791

STANLEY T KIM (M.D.) is a healthcare provider. based in Chicago, Illinois. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials M.D.. They hold a License No. 036-111178 (IL). The NPI Number for STANLEY T KIM (M.D.) is 1790779791

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
STANLEY T KIM (M.D.)
NPI
1790779791
Phone
(773) 880-6792
Address
2300 CHILDREN'S PLAZA, NO. 9
Enumeration Date
6 September 2005
Last Update Date
6 September 2018

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
5593535917
Graduation Year
1999 (27 years ago)
PAC ID
3870527120
Group Practice PAC ID
8022065036
Professional Enrollment ID
I20171017002455
Address ID
CA936368761MA9300XPLXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:20State licenses:3Digital endpointsOther names

2,123 DIAGNOSTIC RADIOLOGY in IL

Provider Addresses for STANLEY T KIM (M.D.)

  • 2300 CHILDREN'S PLAZA, NO. 9

    CHILDREN'S MEMORIAL HOSPITAL

    CHICAGO, IL 606143363

    Phone: (773) 880-6792

    Fax: (773) 880-3517

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $478.

Total Amount is formed as General ($478) + Research ($0) + Ownership ($0) = $478.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Inari Medical, Inc. ($371).

Total Amount

$478

General + Research + Ownership

Payments

7

Total payment records

General Amount

$478

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-10-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171017002455IDiagnostic RadiologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99152Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes1919$0
77012Review by radiologist of ct guidance for needle placement1515$0
View full utilization report →

Insurance plans in this area (ZIP 60614)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022065036View full group profile
NameSpecialtyState
Diagnostic Radiology, Nuclear Medicine, Pediatric MedicineCO
Diagnostic RadiologyCA
Diagnostic RadiologyCA
Diagnostic RadiologyCA
Diagnostic Radiology, Interventional RadiologyMA
Diagnostic RadiologyCA
Diagnostic RadiologyCA
Diagnostic RadiologyOH
Diagnostic RadiologyCA
Diagnostic RadiologyCA

Reviews

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Frequently asked questions

What unique ID ties claims to STANLEY T KIM (M.D.)?
NPI 1790779791 is assigned to STANLEY T KIM (M.D.) under the national enumeration system.
Is STANLEY T KIM (M.D.)'s NPI currently valid?
The extract we use shows STANLEY T KIM (M.D.) as active.
Does STANLEY T KIM (M.D.) list a primary specialty?
If you are matching referrals, note Vascular & Interventional Radiology Physician for STANLEY T KIM (M.D.). Clinical services aligned with this taxonomy classification.
What location shows for STANLEY T KIM (M.D.)?
We surface Chicago, Illinois for STANLEY T KIM (M.D.) based on available NPPES addresses.
What if Chicago, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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