NPIMap

Individual provider Active NPI

Tae Yeon Kim, MD

  • Epilepsy Physician
  • Portland, OR
National Provider Identifier
1518462456
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
MD209828 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone
(503) 494-8211
NPI assigned
Mar 23, 2018
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD209828 OR
Epilepsy Physician 2084E0001X MD209828 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

Other practice location 1

9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643
Phone (503) 216-1150

Other practice location 2

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tkim156975@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802000530 OR Practitioner - Neurology 4688925027 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

5050 NE Hoyt St
Suite 315
Portland, OR 97213-2982
Phone (503) 215-8580

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD209828ORMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
University Professional Services CurrentSince Jul 1, 2023 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jul 31, 2025 Accepting new patients
University Professional Services CurrentSince Jul 1, 2023 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jul 31, 2025 Accepting new patients
University Professional Services Current Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 28, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 28, 2025 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

5050 NE Hoyt St
Ste 315
Portland, OR 97213
Phone (503) 215-8580

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5050 NE Hoyt St
Ste 615
Portland, OR 97213
Phone (503) 215-8580

9135 SW Barnes Rd
Ste 461
Portland, OR 97225
Phone (503) 216-1150

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Interoperability endpoints

  • Direct secure messaging: tkim107357@direct.ohsu.edu
  • Direct secure messaging: tkim156975@secure.stcharleshealthcare.org
  • Direct secure messaging: tkim3780306@oc.providencedirect.org

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1518462456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9135 SW Barnes Rd Ste 461",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256643",
            "country_code": "US",
            "telephone_number": "503-216-1150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 NE Neff Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016015",
            "country_code": "US",
            "telephone_number": "541-382-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAE YEON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD209828",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "OR",
            "license": "MD209828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkim156975@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2500 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.