Individual provider Active NPI

David Ung Kim, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
National Provider Identifier
1376868687
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD60465026 Issued in WA
Practice address
19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4746
Phone
(425) 563-1500
Fax
(425) 563-1501
NPI assigned
Mar 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 63819 WI
Diagnostic Radiology Physician 2085R0202X MD60465026 WA Primary
Body Imaging Physician 2085B0100X MD60465026 WA

Addresses

Primary practice location

19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4746

Mailing address

19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4746
Phone (425) 563-1500

Other identifiers 1

IdentifierTypeStateIssuer
2020282MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NE2 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

Enrollment IDStateProvider typePAC IDDetails
I20160915001394 WA Practitioner - Diagnostic Radiology 3072759547 Reassigns benefits to 7 organizations
I20220915003067 NE Practitioner - Diagnostic Radiology 3072759547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60465026WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Okanogan County Public Hospital District No. 3 CurrentSince Jul 3, 2020 Accepting new patients
Unmc Physicians CurrentSince Sep 1, 2022 Accepting new patients
Radia Inc P S Diagnostic Radiology CurrentSince Aug 2, 2016 Accepting new patients
South Sound Radiologists Inc P S Diagnostic Radiology CurrentSince Jan 1, 2018 Accepting new patients
Evergreen Radia LLC Diagnostic Radiology CurrentSince Aug 2, 2016 Accepting new patients
Nebraska Health Imaging LLC Diagnostic Radiology CurrentSince Jun 1, 2022 Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology CurrentSince Aug 2, 2016 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince Jan 1, 2019 Accepting new patients
Wenatchee Valley Hospital CurrentSince Sep 1, 2016 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince Jan 1, 2019 Accepting new patients

Locations

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

7819 Dodge St
Omaha, NE 68114
Phone (402) 384-8882

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600

810 Jasmine St
Omak, WA 98841
Phone (509) 826-1760

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 455-3600

8980 161st Ave NE
Redmond, WA 98052
Phone (425) 895-4810

911 N 10th Pl
Renton, WA 98057
Phone (425) 391-5700

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

1221 Madison St
Ste 150
Seattle, WA 98104
Phone (206) 215-6433

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

515 Minor Ave
Ste 110
Seattle, WA 98104
Phone (206) 292-6233

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

6101 Summitview Ave
Ste 200
Yakima, WA 98908
Phone (509) 573-3530

Interoperability endpoints

  • Direct secure messaging: dkim410966@direct.nebraskamed.com

Organizations & group practices 10

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.

Hospital & facility affiliations 4

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": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1376868687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364746",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364746",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "UNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "63819",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60465026",
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "WA",
            "license": "MD60465026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020282",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.