Individual provider Active NPI

Lynna Kim, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1477751386
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD4146 Issued in WA
Practice address
9720 4TH Ave NE
Seattle, WA 98115-2143
Phone
(206) 527-6588
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD4146 WA Primary

Addresses

Primary practice location

9720 4TH Ave NE
Seattle, WA 98115-2143

Mailing address

9720 4TH Ave NE
Seattle, WA 98115-2143
Phone (206) 527-6588

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20080218000408 WA Practitioner - Optometry 0749363547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9800 4TH Ave NE
Seattle, WA 98115-2152
Phone (206) 527-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD4146WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 3, 2007 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 3, 2007 Accepting new patients

Locations

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9800 4th Ave NE
Seattle, WA 98115
Phone (206) 302-1200

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: lkim29529@ghc.direct-ci.net

Organizations & group practices 2

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1477751386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 4TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152143",
            "telephone_number": "206-527-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 4TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152143",
            "telephone_number": "206-527-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LYNNA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD4146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9720 4th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981152143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.