Gary Sang Kim, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

153579 Issued in OR

Practice address

15950 SW Millikan Way
Beaverton, OR 97006-5170

Phone

(503) 646-0161

Fax

(503) 643-7459

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Internal Medicine

Education

Uniformed Services Uhs Fe Hebert School of Med, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gkim31862@theportlandclinic.gardenplot.direct-ci.com
• Direct secure messaging: gkim2432@direct.theportlandclinic.net

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.

• Portland Clinic

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1558379099
  Medicare reassignment Care Compare group NPD
• The Portland Clinic Laboratory

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1053448795
  NPD

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

• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1306820667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051902",
            "telephone_number": "503-221-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15950 SW MILLIKAN WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065170",
            "telephone_number": "503-646-0161",
            "fax_number": "503-643-7459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 NE Sandy Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972131941",
            "country_code": "US",
            "telephone_number": "503-233-6940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GARY",
        "middle_name": "SANG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01059242A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "153579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gkim2432@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "15950 SW Millikan Way",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970065170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kidscare Home Health of Oregon LLC
• John Thomas Kightlinger, QMHA
• Eric Hunter Kilber, M.D.
• Jonna Nicole Kilpatrick
• Catherine Bom Kim, D.M.D.
• Jane Jeeyoon Kim, DMD
• Jin Ah Renee Kim, LCSW
• Jonathan Juyun Kim, DDS
• Joshua Kim, D.D.S.
• Kathy S.M. Kim, DDS

• Internal Medicine Physician in Beaverton, OR
• Providers in Beaverton, 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 Nov 16, 2020; 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.