Kyong Ho Kim, DO

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

OP00001595 Issued in WA

Practice address

11306 Bridgeport Way SW
Suite D
Lakewood, WA 98499-3037

Phone

(253) 983-9390

Fax

(253) 983-0066

NPI assigned

Nov 7, 2005

Last updated

Feb 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Interventional Pain ManagementAlso: Pain Management

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sound Pain AllianceGroup PAC ID 0941565162, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Clare Hospital Hospital, Lakewood, WA, CCN 500021

Merit-based Incentive Payment System (MIPS)

Final score

71.86 of 100Reported as group

Quality

61.97

Promoting interoperability

67

Improvement activities

40

Cost

71.75

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Sound Pain Alliance

  dba Black Stone Health

  • Pain Medicine Physician
  • Bellingham, WA
  • NPI 1649776394

  Interventional Pain Medicine

  Medicare reassignment Care Compare group NPD
• Pain Care Physicians PLLC

  • Interventional Pain Medicine Physician
  • Renton, WA
  • NPI 1144779232
  Medicare reassignment NPD
• Puget Sound Pain Clinic PS

  • Interventional Pain Medicine Physician
  • Tukwila, WA
  • NPI 1861739294
  Authorized official Same address or phone
• Sound Pain Alliance

  dba Mt. Baker Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
  • NPI 1457695116
  NPD
• Sound Pain Alliance

  dba Black Stone Health

  • Pain Clinic/Center
  • Corvallis, OR
  • NPI 1437893286
  NPD
• Fox Medical Center

  • Family Medicine Physician
  • University Place, WA
  • NPI 1639748882
  NPD (past)
• Franciscan Medical Group

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1366539421
  NPD (past)
• Sound Pain Alliance

  dba Mt Baker Pain Clinic

  • Pain Clinic/Center
  • Burlington, WA
  • NPI 1538405709
  NPD (past)
• Sports and Spine

  • Clinic/Center
  • Bellevue, WA
  • NPI 1598255903
  NPD (past)

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

• Saint Clare Hospital

  dba Paclab

  • Clinical Medical Laboratory
  • Lakewood, WA
  • NPI 1003029745

  Hospital

  Care Compare affiliation
• Saint Clare Hospital

  dba ST. Clare Hospital

  • General Acute Care Hospital
  • Lakewood, WA
  • NPI 1689672693
  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1124009303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39324",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984963324",
            "telephone_number": "253-983-9390",
            "fax_number": "253-983-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11306 BRIDGEPORT WAY SW",
            "address_2": "SUITE D",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993037",
            "telephone_number": "253-983-9390",
            "fax_number": "253-983-0066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Lilly Rd NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065028",
            "country_code": "US",
            "telephone_number": "206-538-6300",
            "fax_number": "206-538-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYONG",
        "middle_name": "HO",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP00001595",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "OP00001595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002900",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joy Kim, D.D.S
• Jungmi Kim
• Jungmin Judy Kim
• Kathy Kim, O.D.
• Kevin Kim, DDS
• Meilani Kim, OT
• Nayeon Kim, FNP
• Sarah Jisun Kim, PHARMD
• Sophia Kim
• Expery Kimaryo

• Interventional Pain Medicine Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Interventional Pain Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.