Dennis Jooyoung Kim, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00041157 Issued in WA

Practice address

511 10TH Ave SE
Puyallup, WA 98372-3875

Phone

(253) 845-7566

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Consolidated Resources Health Care Fund I, LP

  • Skilled Nursing Facility
  • Federal Way, WA
  • NPI 1881648061

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Bridgeport Medical Clinic PLLC

  • Clinic/Center
  • Puyallup, WA
  • NPI 1982855995
  Medicare reassignment NPD Authorized official
• Consolidated Resources Health Care Fund I, LP

  • Skilled Nursing Facility
  • Federal Way, WA
  • NPI 1881648061
  NPD (past)
• Puyallup Care Center, Inc

  • Skilled Nursing Facility
  • Puyallup, WA
  • NPI 1699760025
  NPD (past)
• Valley Terrace Operations, LLC

  • Skilled Nursing Facility
  • Puyallup, WA
  • NPI 1508811183
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1669586087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 S 295TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033659",
            "telephone_number": "253-797-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 10TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723875",
            "telephone_number": "253-845-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DENNIS",
        "middle_name": "JOOYOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00041157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116136",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Ellen Kilgus, RD
• Kathryn Killingbeck, LMP
• Kim D Nordberg DDS, PS
• Brian Yongil Kim, M.D.
• Cholwoo Anthony Kim, M.D.
• Hyewon Kim
• Jessica Kim, MS, RDN, CD
• Jessica H Kim, MD
• Jiyoung Kim, LSWAIC
• June Kim, MD

• Internal Medicine Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.