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

Ellen H Kim, MD

Individual provider Family Medicine Physician · NPI 1912069329

Ellen H Kim, MD is a Family Practice in Philadelphia, Pennsylvania. Qualified in 2004, 22 years ago. Practices with Dedicated Pennsylvania Holding LLC, an 18-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
22
Licensed in
PA
In the registry since
2006
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

6431 Sackett St
Philadelphia, PA 19149
Phone: (267) 448-4908
Fax: (267) 297-3950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD430049 (PA)

Record details

NPI number1912069329
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 14, 2006
Last updated in NPPESAugust 9, 2023
Certification dateAugust 9, 2023

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Dedicated Pennsylvania Holding Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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