Song Jin Sunny Kim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD23572 Issued in OR

Practice address

426 SW Stark St
8TH Floor
Portland, OR 97204-2347

Phone

(503) 988-3674

Fax

(503) 988-5305

NPI assigned

Jan 17, 2007

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

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Specialty

Internal Medicine

Education

New York University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Merit-based Incentive Payment System (MIPS)

Final score

92.83 of 100Reported as group

Quality

96.26

Promoting interoperability

100

Improvement activities

40

Cost

79.84

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment Care Compare group NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Internal Medicine

  Medicare reassignment NPD
• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment NPD
• Silverton Health

  • Clinic/Center
  • Woodburn, OR
  • NPI 1215347109
  NPD
• Silverton Health

  • Clinic/Center
  • Molalla, OR
  • NPI 1861116055
  NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD

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

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare affiliation

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1275685455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST",
            "address_2": "210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041817",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST",
            "address_2": "8TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SONG",
        "middle_name": "JIN SUNNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD23572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane K. Kim, MD
• Sharon Bokyong Kim, M.D.
• Sherry Michelle Kim, MD
• Sik Kiyoshi Kim, MD
• Sohyon Kim
• Soonie Ann Kim, PHD
• Stephanie Kim
• Tae Yeon Kim, MD
• Tiffany Kim, O.D.
• Yongsung Kim, MD

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.