Individual provider Active NPI

Kyu Seo Kim

  • Pediatric Critical Care Medicine Physician
  • Washington, DC
National Provider Identifier
1467985994
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
MD600006283 Issued in DC
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(202) 476-5000
NPI assigned
Apr 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD600006283 DC
Pediatric Critical Care Medicine Physician 2080P0203X MD600006283 DC Primary
Pediatrics Physician 208000000X A157291 CA
Pediatric Critical Care Medicine Physician 2080P0203X A157291 CA

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157291CAMDPediatric Critical Care Medicine Physician
MD214632ORMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Counties Pediatric Critical Care Medical Group Pediatric Critical Care Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1467985994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYU SEO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD600006283",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "DC",
            "license": "MD600006283",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157291",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A157291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.