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

Taewan Kim, MD

Individual provider Surgery Physician · NPI 1992757421

Taewan Kim, MD is a General Surgery in Oswego, New York. Graduated from State University of Ny Upstate Medical University in 1996, 30 years ago. Practices with Physician Care PC, a 77-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
30
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
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

140 W 6th St Ste LL30
Oswego, NY 13126-2564
Phone: (315) 349-5511
Fax: (315) 349-5921
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 505 Irving Ave, Syracuse, NY 13210-1718 — (315) 464-9852

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 220630 (NY)

Record details

NPI number1992757421
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 16, 2006
Last updated in NPPESMarch 29, 2023
Certification dateMarch 29, 2023
Mailing address110 W 6th St, Oswego, NY 13126-2507

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 1996 (30 years in practice)
Group practice Physician Care Pc — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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