Warren Tackhoon Kim, M.D., PH.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

A91921 Issued in CA

Practice address

1100 Van Ness Ave
San Francisco, CA 94109-6978

Phone

(415) 600-0528

Fax

(415) 369-1207

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Yale University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
• Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007
• California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: wkim183373@hisp.ehr.sutterhealth.org

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

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Orinda, CA
  • NPI 1366898538

  Diagnostic Radiology

  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Neurovascular Medical Group, Inc

  • Specialist
  • San Francisco, CA
  • NPI 1730126103
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1730238007
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769

  Diagnostic Radiology

  NPD (past)
• University of California San Francisco

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Francisco, CA
  • NPI 1992818256
  NPD (past)

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

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Menlo Park, CA
  • NPI 1295199701
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1740348929
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation
• Sutter Coast Hospital

  • General Acute Care Hospital
  • Crescent City, CA
  • NPI 1457367062
  Care Compare affiliation
• Sutter Coast Hospital

  • General Practice Physician
  • Crescent City, CA
  • NPI 1700960267

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1063532778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "415-600-0528",
            "fax_number": "415-369-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096978",
            "telephone_number": "415-600-0528",
            "fax_number": "415-369-1207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Castro Street",
            "address_2": "California Advanced Imaging Medical Associates",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94114",
            "country_code": "US",
            "telephone_number": "415-600-7760",
            "fax_number": "415-600-7765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "WARREN",
        "middle_name": "TACKHOON",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A91921",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "893219",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A91921",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "893219",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A91921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063532778",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A91921",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01266715",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tae Un Kim, DO
• Terry Kim, MD
• Thomas Lee Kim, LMFT
• Timothy Kim
• Tyson Kim, M.D, PH.D.
• Won Kim, MD
• Woo Ree Kim
• Woon Cho Kim
• Xander Hanjune Kim, DPM
• Yekaterina Kim

• Vascular & Interventional Radiology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.