Ellen M Kim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00046853 Issued in WA

Practice address

560 Gage Blvd Ste 206
Richland, WA 99352-8650

Phone

(509) 942-3286

Fax

(509) 628-1354

NPI assigned

Jun 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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

Internal Medicine

Education

Temple University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-Cities Home Health Home health agency, Kennewick, WA, CCN 507010
• Columbia River Home Health Home health agency, Kennewick, WA, CCN 507061
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment NPD
• Kadlec Regional Medical Center

  • Rehabilitation Hospital Unit
  • Richland, WA
  • NPI 1790319580
  NPD
• Providence Health & Services-Washington

  • Internal Medicine Physician
  • Everett, WA
  • NPI 1821249921
  NPD
• Northwestern Medical Associates PC

  • Internal Medicine Physician
  • Fort Washington, PA
  • NPI 1407806003
  NPD (past)

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

• Iron Bridge Healthcare, Inc.

  • Home Health Agency
  • Kennewick, WA
  • NPI 1699263079
  Care Compare affiliation
• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation
• Tri-Cities Home Health, LLC

  • Home Health Agency
  • Kennewick, WA
  • NPI 1679547244
  Care Compare affiliation

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1124024229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD STE 206",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528650",
            "telephone_number": "509-942-3286",
            "fax_number": "509-628-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELLEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00046853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8458986",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekim122061@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "560 Gage Blvd Ste 206",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993528650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suzanne Larayne Kieffer, MSW
• Cindy JD Kieneker, MSW
• Debra Ann Kietzman, RN, LMP
• Alexa R Killin, OT
• Kim Kare Geriatrics PLLC
• Paridhi Kimble, DMD, M.S.
• Kay Kimmel, MASSAGE PRACTITIONER
• Ronald E. King, M.ED.
• Susanna King, ARNP
• Caitlin Elizabeth Kinsey, ARNP

• Internal Medicine Physician in Richland, WA
• Providers in Richland, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.