Active NPI
Kyu Seo Kim
- Pediatric Critical Care Medicine Physician
- Washington, DC
National Provider Identifier
1467985994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- MD600006283
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A157291 | CA | MD | Pediatric Critical Care Medicine Physician |
| MD214632 | OR | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Pediatric Critical Care Medicine Physician
- Fountain Valley, CA
- NPI 1609853688
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.