Individual provider Active NPI

Leigh Hyun Kim, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1417450503
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60836930 Issued in WA
Practice address
4401 4TH Ave S
Seattle, WA 98134
Phone
(206) 403-2027
NPI assigned
Mar 14, 2018
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60836930 WA Primary

Addresses

Primary practice location

4401 4TH Ave S
Seattle, WA 98134

Mailing address

4401 4TH Ave S
Seattle, WA 98134-2311

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200203002135 WA Practitioner - Optometry 1557797958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eric Vo OD LLCGroup PAC ID 5193052074, 5 clinicians

Practice addresses (Care Compare)

4401 4TH Ave S
Seattle, WA 98134-2311
Phone (206) 403-2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60836930WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Vo OD LLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients

Locations

4401 4th Ave S
Seattle, WA 98134
Phone (206) 403-2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1417450503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 4TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981342311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 4TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98134",
            "telephone_number": "206-403-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LEIGH",
        "middle_name": "HYUN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60836930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.