Individual provider Active NPI

Dohyun Kim, PA-C

  • Physician Assistant
  • Saipan, MP
National Provider Identifier
1447928049
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
121 Issued in MP
Practice address
1178 Hinemlu Street,
Saipan, MP 96950
Phone
(670) 234-8950
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 121 MP Primary

Addresses

Primary practice location

1178 Hinemlu Street,
Saipan, MP 96950

Mailing address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Other practice location 1

4311 11th Ave NE Ste 200
Seattle, WA 98105-6367
Phone (206) 616-4011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230501001564 MP Practitioner - Physician Assistant 0941665749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Healthcare CorporationGroup PAC ID 7719075167, 79 clinicians

Practice addresses (Care Compare)

1 Lower Navy Hill Rd
Saipan, MP 96950
Phone (670) 234-8950

PO Box
Saipan, MP 96950

Hospital & facility affiliations

  • Commonwealth Health Center Hospital, Garapan, MP, CCN 660001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
121MPMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation CurrentSince Dec 28, 2022 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Dec 28, 2022 Accepting new patients

Organizations & group practices 3

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1447928049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 HINEMLU STREET,",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "96950",
            "telephone_number": "670-234-8950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DOHYUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MP",
            "license": "121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saipan, MP

Sources for this page

Verify at the official NPI Registry.