Individual provider Active NPI

Donna Hyunchung Kim, MD

  • Ophthalmology Physician
  • Portland, OR
National Provider Identifier
1073769592
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD152819 Issued in OR
Practice address
3303 SW Bond Avenue
Casey Eye Physicians and Surgeons, Ohsu, 11TH Floor
Portland, OR 97239-4501
Phone
(503) 494-3000
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD152819 OR Primary

Addresses

Primary practice location

3303 SW Bond Avenue
Casey Eye Physicians and Surgeons, Ohsu, 11TH Floor
Portland, OR 97239-4501

Mailing address

3303 SW Bond Avenue
Casey Eye Physicians and Surgeons, Ohsu, 11TH Floor
Portland, OR 97239
Phone (503) 494-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20101130001327 OR Practitioner - Ophthalmology 1254527369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Stanford University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD152819ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Dec 1, 2010 Accepting new patients
University Professional Services Past Accepting new patients

Locations

2055 Exchange St
Ste 230
Astoria, OR 97103
Phone (503) 338-3803

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3303 S Bond Ave
Fl 11
Portland, OR 97239
Phone (503) 418-1430

312 SE Stonemill Dr
Ste 150
Vancouver, WA 98684
Phone (360) 254-2323

Interoperability endpoints

  • Direct secure messaging: dkimmd578@direct.ohsu.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1073769592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVENUE",
            "address_2": "CASEY EYE PHYSICIANS AND SURGEONS, OHSU, 11TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-494-3000",
            "fax_number": "503-418-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVENUE",
            "address_2": "CASEY EYE PHYSICIANS AND SURGEONS, OHSU, 11TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONNA",
        "middle_name": "HYUNCHUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD152819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.