Active NPI
Daniel Byeongheui Kim, MD
- Vascular Surgery Physician
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD61068288
- Practice address
- 1330 Rockefeller Ave Ste 520
Everett, WA 98201-1677 - Phone
- (425) 297-5200
- Fax
- (425) 259-8600
- NPI assigned
- Apr 25, 2013
- Last updated
- Sep 16, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | MD61068288 | WA | Primary |
Addresses
Primary practice location
1330 Rockefeller Ave Ste 520
Everett, WA 98201-1677
Mailing address
1330 Rockefeller Ave Ste 520
Everett, WA 98201-1677
Phone (877) 644-8346
Other practice location 1
55 Fruit St
Boston, MA 02114
Phone (877) 644-8346
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Cincinnati College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000
1330 Rockefeller Ave
Everett, WA 98201-1677
4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 15 |
| Varicose vein removal | 11 |
| Leg revascularization (restoring blood flow) | 20 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61068288 | WA | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Washington | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Providence Health & Services- Washington | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Pacific Vascular Incorporated | Current | Accepting new patients | |
| Providence Health & Services-Wa | Past | Accepting new patients |
Locations
1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076
1330 Rockefeller Ave
Ste 520
Everett, WA 98201
Phone (425) 297-5200
4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330
Interoperability endpoints
- dkim1315152@wm.providencedirect.org
Organizations & group practices 17
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.
-
dba PMG NW Wa
- General Practice Physician
- Everett, WA
- NPI 1124270715
-
- Physiological Laboratory
- Kennewick, WA
- NPI 1023932944
-
- Physiological Laboratory
- Auburn, WA
- NPI 1043365257
-
dba Pacific Vascular-Cherry Hill
- Physiological Laboratory
- Seattle, WA
- NPI 1154476216
-
- Physiological Laboratory
- Seattle, WA
- NPI 1245385467
-
- Physiological Laboratory
- Bellingham, WA
- NPI 1295145894
-
dba Pacific Vascular-First Hill
- Physiological Laboratory
- Seattle, WA
- NPI 1295880433
-
- Physiological Laboratory
- Port Ludlow, WA
- NPI 1336019314
-
dba Pacific Vascular-Edmonds
- Physiological Laboratory
- Edmonds, WA
- NPI 1558417675
-
- Physiological Laboratory
- Bothell, WA
- NPI 1619300308
-
- Physiological Laboratory
- Port Angeles, WA
- NPI 1639776842
-
- Physiological Laboratory
- Bothell, WA
- NPI 1750436945
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Regional Medical Center Everett
- Hospitalist Physician
- Everett, WA
- NPI 1649615220
-
- General Acute Care Hospital
- Everett, WA
- NPI 1700037801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1639513229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 ROCKEFELLER AVE STE 520",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011677",
"telephone_number": "877-644-8346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 ROCKEFELLER AVE STE 520",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011677",
"telephone_number": "425-297-5200",
"fax_number": "425-259-8600"
}
],
"practiceLocations": [
{
"address_1": "55 Fruit St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "02114",
"country_code": "US",
"telephone_number": "877-644-8346",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "DANIEL",
"middle_name": "BYEONGHEUI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-25",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WA",
"license": "MD61068288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.