Physician Compare National (NPI:1841510534)

HEALTHCARE PROVIDER: REBEKAH KIM M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1841510534
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759545122
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190619001872
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KIM
	Individual professional last name
Provider First Name	REBEKAH
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEISEL SCHOOL OF MEDICINE AT DARTMOUTH
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	COLORECTAL SURGERY (PROCTOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FAIRFAX COLON AND RECTAL SURGERY PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4385628411
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	44055 RIVERSIDE PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	108B
	Group Practice or individual's line 2 address
City	LEESBURG
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	201765155
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5715103862
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490063
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	INOVA FAIRFAX HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490101
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INOVA FAIR OAKS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y