Active NPI 1134129679 Individual Practitioner Male Practitioner

Dr. Samuel Chan Kim , MD

Urology • Lafayette, IN

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Kim, MD is a certified Urology practicing in Lafayette, IN. With approximately 30 years of clinical experience since graduating from Northwestern University Feinberg Medical School in 1996, Dr. Kim delivers high-quality medical care to the local community at 5165 MCCARTY LN.

Dr. Kim maintains professional affiliations with Iu Health Medical Group Llc, Indiana University Health Ball Memorial Physicians Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, ultrasound measurement of bladder capacity after voiding. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5165 Mccarty Ln

Lafayette, IN 479058764

Telephone 7654488000

Fax 7654487619

Associated Practice Facility / Clinic

🏢 Arnett Clinic, Llc Facility NPI 1164490843

Medicare Profile & Education

Medical School

Northwestern University Feinberg Medical School

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Lafayette, IN

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

30 Yrs +7.6 yrs vs City Avg

City Avg: 22.4 Yrs

State Avg: 27.2 Yrs

Regional Practice Density

20 Specialists

Practicing in Lafayette, IN (320 Statewide)

Telehealth Adoption Rate

45.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

70.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kim (30 Years) 30 Yrs

Lafayette Specialty Average (22.4 Years) 22.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	248	173	$183.00	$126.14
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	210	170	$35.00	$16.34
51798 Ultrasound measurement of bladder capacity after voiding	138	109	$108.00	$10.73
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	90	90	$289.00	$162.92
81003 Automated urinalysis test	67	62	$12.00	$2.20
52000 Diagnostic exam of bladder and urethra using an endoscope	65	50	$500.00	$229.03
99213 Established patient office or other outpatient visit, typically 15 minutes	50	45	$128.08	$89.08
74420 Imaging of urinary tract	50	40	$64.00	$23.88
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	20	$267.00	$128.37
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	22	19	$253.00	$178.07
99231 Follow-up hospital inpatient care per day, typically 15 minutes	20	14	$83.00	$48.63
52005 Insertion of tube into ureter using an endoscope through bladder area	19	17	$1076.00	$55.47
52356 Crushing of stone of ureter with insertion of stent using an endoscope	18	16	$1390.00	$400.07
52332 Insertion of stent in urinary duct (ureter) using an endoscope	18	17	$1161.39	$107.69
55700 Biopsy of prostate gland	11	11	$595.00	$234.09
76872 Ultrasound scan of pelvic region through rectum	11	11	$429.00	$134.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	32	31	$165.00	$121.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	31	31	$218.00	$157.31
51798 Ultrasound measurement of bladder capacity after voiding	19	16	$55.00	$9.75
99213 Established patient office or other outpatient visit, typically 15 minutes	18	18	$112.00	$85.38
74420 Imaging of urinary tract	15	12	$54.47	$22.38
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	13	$239.29	$123.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$150.00	$105.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	686	519	$10.00	$3.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	449	334	$243.16	$121.17
51798 Ultrasound measurement of bladder capacity after voiding	211	177	$19.00	$9.50
99213 Established patient office or other outpatient visit, typically 15 minutes	150	136	$172.00	$85.30
36415 Insertion of needle into vein for collection of blood sample	138	128	$7.00	$2.97
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	116	20	$683.00	$171.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	77	77	$316.00	$157.56
52000 Diagnostic exam of bladder and urethra using an endoscope	68	50	$400.00	$224.71
74420 Imaging of urinary tract	59	42	$49.64	$23.99
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	47	$106.00	$52.09
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	32	30	$375.00	$184.50
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	30	23	$62.00	$30.24
52332 Insertion of stent in urinary duct (ureter) using an endoscope	29	26	$300.00	$118.10
51702 Simple insertion of temporary bladder tube	26	17	$117.00	$57.23
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	23	22	$343.00	$170.99
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	15	$777.00	$400.82
55700 Biopsy of prostate gland	17	17	$550.00	$228.79
76872 Ultrasound scan of pelvic region through rectum	17	17	$250.00	$131.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$211.00	$105.54
52287 Exam with injections of chemical for destruction of bladder using an endoscope	15	15	$317.00	$148.27
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	15	14	$459.00	$209.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	1,033	694	$10.00	$3.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	579	439	$244.41	$123.15
51798 Ultrasound measurement of bladder capacity after voiding	405	278	$19.55	$9.35
99213 Established patient office or other outpatient visit, typically 15 minutes	264	236	$171.73	$86.95
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	162	162	$316.18	$158.95
36415 Insertion of needle into vein for collection of blood sample	157	144	$7.00	$3.00
52000 Diagnostic exam of bladder and urethra using an endoscope	119	81	$400.00	$220.43
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	104	15	$683.00	$179.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	94	89	$106.00	$53.37
74420 Imaging of urinary tract	57	48	$47.79	$24.01
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	53	52	$378.92	$191.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$210.54	$106.65
52332 Insertion of stent in urinary duct (ureter) using an endoscope	33	24	$298.76	$111.53
99442 Telephone medical discussion with physician, 11-20 minutes	33	29	$78.00	$76.90
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	32	17	$60.00	$30.44
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	29	29	$339.83	$173.03
51702 Simple insertion of temporary bladder tube	26	12	$118.81	$60.26
99231 Follow-up hospital inpatient care per day, typically 15 minutes	25	20	$73.00	$36.80
52005 Insertion of tube into ureter using an endoscope through bladder area	21	19	$249.05	$83.38
76872 Ultrasound scan of pelvic region through rectum	21	21	$250.00	$131.38
55700 Biopsy of prostate gland	21	21	$550.00	$237.34
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	20	17	$42.00	$21.38
52648 Laser vaporization of prostate including control of bleeding using an endoscope	17	17	$1209.00	$622.60
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	17	16	$463.00	$207.69
81000 Manual urinalysis test with examination using microscope, non-automated	15	15	$10.00	$4.02
52356 Crushing of stone of ureter with insertion of stent using an endoscope	13	13	$844.31	$411.04
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	11	11	$538.91	$266.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	958	652	$10.00	$3.45
99213 Established patient office or other outpatient visit, typically 15 minutes	584	467	$140.71	$70.86
51798 Ultrasound measurement of bladder capacity after voiding	308	245	$19.88	$9.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	269	224	$204.86	$103.56
36415 Insertion of needle into vein for collection of blood sample	185	169	$7.00	$2.97
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	139	18	$683.00	$219.64
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	137	137	$308.96	$156.36
52000 Diagnostic exam of bladder and urethra using an endoscope	133	89	$400.00	$200.13
99442 Telephone medical discussion with physician, 11-20 minutes	87	85	$78.00	$71.18
99231 Follow-up hospital inpatient care per day, typically 15 minutes	68	38	$75.06	$38.20
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	66	64	$385.95	$196.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	51	49	$84.94	$42.43
52332 Insertion of stent in urinary duct (ureter) using an endoscope	39	26	$348.87	$138.84
99441 Telephone medical discussion with physician, 5-10 minutes	35	32	$40.00	$40.01
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	34	20	$58.97	$29.71
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	34	30	$275.74	$137.19
74420 Imaging of urinary tract	34	27	$53.00	$23.94
52005 Insertion of tube into ureter using an endoscope through bladder area	30	25	$253.70	$67.55
51702 Simple insertion of temporary bladder tube	26	13	$115.46	$58.13
99443 Telephone medical discussion with physician, 21-30 minutes	22	22	$115.00	$103.54
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	22	19	$470.55	$234.67
81000 Manual urinalysis test with examination using microscope, non-automated	20	19	$10.00	$3.99
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$202.00	$101.27
52356 Crushing of stone of ureter with insertion of stent using an endoscope	18	17	$797.00	$394.30
52648 Laser vaporization of prostate including control of bleeding using an endoscope	17	17	$1328.24	$677.56
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	15	14	$679.00	$152.12
55700 Biopsy of prostate gland	15	15	$550.00	$237.37
76872 Ultrasound scan of pelvic region through rectum	15	15	$250.00	$135.84
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	13	12	$42.85	$21.84
52281 Dilation of bladder canal (urethra) using an endoscope	13	11	$291.85	$136.55
52287 Exam with injections of chemical for destruction of bladder using an endoscope	12	11	$324.58	$165.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	1,304	854	$10.00	$3.40
99213 Established patient office or other outpatient visit, typically 15 minutes	845	656	$139.16	$70.28
51798 Ultrasound measurement of bladder capacity after voiding	413	301	$23.32	$11.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	354	283	$208.27	$102.99
36415 Insertion of needle into vein for collection of blood sample	269	232	$7.00	$2.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	201	201	$313.07	$155.09
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	146	22	$683.00	$224.53
52000 Diagnostic exam of bladder and urethra using an endoscope	135	89	$400.00	$178.03
99231 Follow-up hospital inpatient care per day, typically 15 minutes	95	50	$76.00	$37.64
74420 Imaging of urinary tract	68	50	$50.51	$24.01
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	57	21	$34.32	$15.80
52332 Insertion of stent in urinary duct (ureter) using an endoscope	56	42	$358.14	$124.37
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	53	53	$387.02	$193.70
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	50	47	$278.00	$136.66
51702 Simple insertion of temporary bladder tube	40	17	$118.00	$58.53
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	37	24	$479.08	$227.37
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	33	20	$58.00	$28.51
81000 Manual urinalysis test with examination using microscope, non-automated	31	27	$10.00	$3.94
55700 Biopsy of prostate gland	25	25	$550.00	$236.87
76872 Ultrasound scan of pelvic region through rectum	24	24	$250.00	$120.75
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	24	22	$39.88	$21.44
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	16	$263.00	$130.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	16	$85.00	$42.54
52287 Exam with injections of chemical for destruction of bladder using an endoscope	16	15	$329.25	$163.54
52281 Dilation of bladder canal (urethra) using an endoscope	15	14	$295.20	$147.03
52648 Laser vaporization of prostate including control of bleeding using an endoscope	14	14	$1342.00	$667.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$205.00	$102.07
52356 Crushing of stone of ureter with insertion of stent using an endoscope	13	12	$810.00	$403.22
52005 Insertion of tube into ureter using an endoscope through bladder area	13	12	$258.00	$99.72
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	12	12	$690.42	$329.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	1,343	855	$10.00	$3.39
99213 Established patient office or other outpatient visit, typically 15 minutes	918	663	$137.00	$68.45
51798 Ultrasound measurement of bladder capacity after voiding	461	338	$29.00	$14.42
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	432	224	$50.00	$39.81
36415 Insertion of needle into vein for collection of blood sample	306	244	$7.00	$2.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	258	216	$203.00	$100.08
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	233	27	$683.00	$212.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	211	211	$315.00	$153.15
52000 Diagnostic exam of bladder and urethra using an endoscope	122	88	$400.00	$154.54
99231 Follow-up hospital inpatient care per day, typically 15 minutes	97	59	$74.00	$37.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	68	64	$82.00	$41.11
74420 Imaging of urinary tract	66	49	$34.00	$17.12
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	47	28	$58.00	$28.71
52332 Insertion of stent in urinary duct (ureter) using an endoscope	42	28	$416.48	$127.89
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	38	38	$273.00	$136.89
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	35	34	$257.00	$129.45
99221 Initial hospital inpatient care per day, typically 30 minutes	31	27	$197.00	$95.42
51702 Simple insertion of temporary bladder tube	28	14	$133.00	$59.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	25	$392.00	$188.33
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	23	17	$470.00	$232.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$205.00	$99.77
81000 Manual urinalysis test with examination using microscope, non-automated	20	20	$10.00	$3.94
52005 Insertion of tube into ureter using an endoscope through bladder area	20	19	$260.00	$94.34
52648 Laser vaporization of prostate including control of bleeding using an endoscope	19	17	$1316.00	$660.73
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	18	16	$38.00	$20.18
76872 Ultrasound scan of pelvic region through rectum	16	16	$250.00	$87.30
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	16	16	$200.00	$54.92
55700 Biopsy of prostate gland	16	16	$550.00	$234.97
52281 Dilation of bladder canal (urethra) using an endoscope	12	12	$290.00	$140.13
55700 Biopsy of prostate gland	12	12	$550.00	$120.27
76872 Ultrasound scan of pelvic region through rectum	12	12	$250.00	$32.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	1,341	846	$7.15	$3.41
99213 Established patient office or other outpatient visit, typically 15 minutes	838	614	$134.00	$68.52
51798 Ultrasound measurement of bladder capacity after voiding	399	286	$49.80	$17.51
36415 Insertion of needle into vein for collection of blood sample	277	222	$7.00	$2.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	216	199	$205.38	$101.30
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	181	24	$683.00	$206.66
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	170	170	$263.04	$152.88
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	162	148	$82.48	$40.22
52000 Diagnostic exam of bladder and urethra using an endoscope	156	118	$396.29	$153.44
99231 Follow-up hospital inpatient care per day, typically 15 minutes	135	56	$75.76	$37.31
74420 Imaging of urinary tract	109	64	$40.44	$17.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$159.89	$101.22
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	58	29	$60.26	$30.13
52332 Insertion of stent in urinary duct (ureter) using an endoscope	50	41	$629.44	$105.91
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	47	44	$206.74	$130.11
51702 Simple insertion of temporary bladder tube	44	19	$184.32	$57.41
81000 Manual urinalysis test with examination using microscope, non-automated	34	31	$7.88	$4.26
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	31	30	$355.58	$193.00
76872 Ultrasound scan of pelvic region through rectum	25	25	$158.76	$85.65
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	25	25	$139.08	$54.59
55700 Biopsy of prostate gland	25	25	$411.60	$232.63
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	23	16	$541.35	$217.28
52204 Biopsy of the bladder using an endoscope	21	20	$772.14	$106.55
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	21	20	$48.05	$18.90
52005 Insertion of tube into ureter using an endoscope through bladder area	20	20	$399.50	$96.83
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	17	16	$516.41	$288.72
52281 Dilation of bladder canal (urethra) using an endoscope	17	17	$396.00	$142.40
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	15	$165.00	$136.28
52648 Laser vaporization of prostate including control of bleeding using an endoscope	14	14	$1969.64	$661.54
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	13	12	$271.92	$31.37
55700 Biopsy of prostate gland	12	12	$537.50	$120.94
76872 Ultrasound scan of pelvic region through rectum	12	12	$272.50	$32.55

Medical Specialties & State Licenses

CMS Verified: 2023-08-11

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License IN 01058979A

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

200476300A (IN)

Commercial Insurance / Payer ID Medicare Ptan

815500539 (IN)

Hospital & Practice Group Affiliations

Indiana University Health Ball Memorial Physicians Inc

2401 W University Ave, Muncie, IN 473033428

Phone: 7657473111

Iu Health Medical Group Llc

1701 N Senate Blvd, Indianapolis, IN 462021239

Phone: 8884843258

Secondary Practice Locations

2525 W University Ave, Suite 504

Muncie, IN 473033421

Phone: 7652897444

5177 Mccarty Ln

Lafayette, IN 479058764

Phone: 7654488000

2401 W University Ave

Muncie, IN 473033428

Phone: 7657411515

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Sidney Bruce , MD

Surgery

NPI 1003044520

Doctor of Medicine (M.D.)

Dr. Michelle Herberts , MD

Internal Medicine - Critical Care Medicine

NPI 1003270786

Doctor of Medicine (M.D.)

Betty Wellman , NP

Nurse Practitioner - Family

NPI 1003351750

Nurse Practitioner

Dr. Kathryn Stucker , MD

Student in an Organized Health Care Education/Training Program

NPI 1003495391

Doctor of Medicine (M.D.)

Dani'el Mckillip , RN

Registered Nurse - Obstetric, Inpatient

NPI 1003604265

Registered Nurse

Abigail Crum , FNP-BC

Nurse Practitioner - Family

NPI 1003687005

Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location December 16, 2022

Registered at 5165 MCCARTY LN, LAFAYETTE, IN 479058764 (Tel: 7654488000)

📍

Updated Business Mailing Address December 16, 2022

Registered at 250 N SHADELAND AVE, INDIANAPOLIS, IN 462194959

✅

NPI Profile Active June 12, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location June 12, 2013

Registered at 2525 W UNIVERSITY AVE, SUITE 504, MUNCIE, IN 473033421 (Tel: 7652897444)

📍

Updated Business Mailing Address June 12, 2013

Registered at 2525 W UNIVERSITY AVE, SUITE 504, MUNCIE, IN 473033421 (Tel: 7652897444)

👤

Provider Name / Credentials Updated June 12, 2013

Recorded as SAMUEL KIM, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 12, 2013

Urology (License #01058979A in IN)

🟢

Initial NPI Registration & Enumeration July 27, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1134129679

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 27, 2005

Last Update: August 11, 2023

Sole Proprietor: No

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Mailing Address

250 N Shadeland Ave

Indianapolis, IN 462194959

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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