Individual provider Active NPI

June Kim, MD

  • MOHS-Micrographic Surgery Physician
  • Puyallup, WA
National Provider Identifier
1205975240
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD60207521 Issued in WA
Practice address
1703 Meridian St S Ste 101
Puyallup, WA 98371-7590
Phone
(253) 848-3000
Fax
(253) 840-6514
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A88217 CA
Dermatology Physician 207N00000X 048561 CT
Dermatology Physician 207N00000X MD60207521 WA
MOHS-Micrographic Surgery Physician 207ND0101X MD60207521 WA Primary

Addresses

Primary practice location

1703 Meridian St S Ste 101
Puyallup, WA 98371-7590

Mailing address

1703 Meridian St S Ste 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110805000443 WA Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 5496895294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
University of Texas Southwestern Medical School at Dallas, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascade Eye and Skin Centers PCGroup PAC ID 4486541554, 47 clinicians

Practice addresses (Care Compare)

1703 S Meridian
Suite 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision52
Removal of tissue1-10
Removal of skin lesions263
Removal of skin cancer787
Removal or shaving of skin growth1-10
Skin biopsy119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88217CAMDDermatology Physician
MD60207521WAMDDermatology Physician

Organizations & group practices 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1205975240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 MERIDIAN ST S STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MERIDIAN ST S STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A88217",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "048561",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60207521",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD60207521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.