Look up the most recent NPI and PECOS records

Sang Hyup Chae-Kim

Anesthesiology

Allopathic & Osteopathic Physicians

12222 Merit Dr Ste 600, Dallas, TX 75251-3294

(972) 715-5000 (972) 233-1999

PECOS Enrollment

This provider is enrolled in PECOS as SANG CHAE KIM.

Based on the most recent information from CMS, provider Sang Hyup Chae-Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1124020342
Provider Type
Individual
Full Name
Chae-Kim, Sang Hyup
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/1/2005
Last Updated
7/19/2022

Contact Information

Practice Location

12222 Merit Dr Ste 600, Dallas, TX 75251-3294

(972) 715-5000

(972) 715-9976

Mailing Location

PO Box 840853, Dallas, TX 75284-0853

(972) 233-1999

(972) 233-3666

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License L8007 Texas
Code 174400000X	Description Specialist Other Service Providers	License L8007 Texas

Provider Identifiers

ID	Description	Issuer
ID 176428407	Description Medicaid	Issuer Unlisted Texas
ID 8EH373	Description Other	Issuer BCBS Texas

Sang Hyup Chae-Kim

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Oruwari, Ivrie

Odinkemelu, Didi Stephanie

Kaufman, Rachel Kozinn

Pucylowski, Austin Jeffrey

Fitzgerald, Brian Michael

Elevated Practice Solutions Inc

Adcock, William Robert

Jensen, Andrew

Johnson, Stacie N

Villarreal, Mark Charles