NPIMap

Individual provider Active NPI

Danny Song Kim, M.D.

  • Surgery Physician
  • Auburn, WA
National Provider Identifier
1013125046
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60650940 Issued in WA
Practice address
121 N Division St Ste 202
Auburn, WA 98001-4931
Phone
(253) 735-0843
NPI assigned
May 21, 2007
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01063684A IN
Surgery Physician 208600000X P5094 TX
Surgery Physician 208600000X MD60650940 WA Primary

Addresses

Primary practice location

121 N Division St Ste 202
Auburn, WA 98001-4931

Mailing address

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161006002426 WA Practitioner - General Surgery 2062643901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at San Antonio, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-1677

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)23
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01063684AINMDSurgery Physician
P5094TXMDSurgery Physician
MD60650940WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Sep 7, 2016 Accepting new patients
Multicare Health System CurrentSince Sep 7, 2016 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

121 N Division St
Ste 202
Auburn, WA 98001
Phone (253) 545-5990

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1013125046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N DIVISION ST STE 202",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014931",
            "telephone_number": "253-735-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANNY",
        "middle_name": "SONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01063684A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P5094",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60650940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.