Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Peter K Kim, MD

Individual provider Surgery Physician · NPI 1205943511

Dr. Peter K Kim, MD is a General Surgery in Warwick, Rhode Island. Qualified in 1997, 29 years ago. Practices with Tanana Valley Clinic LLC, a 142-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York and Rhode Island.

Years since qualifying
29
Licensed in
NY, RI
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone: (401) 737-7010
Fax: (401) 738-0013
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 241 North Rd, Poughkeepsie, NY 12601-1154 — (845) 483-5000

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence MD18930 (RI)
Surgery Physician Taxonomy 208600000X · Licence 235272 (NY)

Record details

NPI number1205943511
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 23, 2006
Last updated in NPPESJanuary 9, 2023
Certification dateJanuary 9, 2023
Mailing address55 First St, Apt. 312, Pelham, NY 10803-1451

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Tanana Valley Clinic Llc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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