Individual provider Active NPI

Richard Dong Suk Kim, MD

  • Pulmonary Disease Physician
  • Renton, WA
National Provider Identifier
1679673669
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD60024762 Issued in WA
Practice address
4011 Talbot Rd S
Ste 460
Renton, WA 98055-5773
Phone
(425) 251-5110
Fax
(425) 793-7382
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD60024762 WA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD60024762 WA
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD60024762 WA

Addresses

Primary practice location

4011 Talbot Rd S
Ste 460
Renton, WA 98055-5773

Mailing address

PO Box 59028
Renton, WA 98058-2028
Phone (425) 251-5110

Other identifiers 1

IdentifierTypeStateIssuer
2002241MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090713000522 WA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1951453570 Reassigns benefits to 1 organization
I20100323000667 TX Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1951453570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
University of California, San Francisco School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

4033 Talbot Rd S
Suite 500
Renton, WA 98055-5704
Phone (425) 656-5365

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton CurrentSince Oct 1, 2017 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 18, 2012 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

7203 129th Ave SE
#280
Newcastle, WA 98056
Phone 42525151103014

4011 Talbot Rd S
Ste 460
Renton, WA 98055
Phone (425) 251-5110

3600 Lind Ave SW
Ste 100
Renton, WA 98057

4033 Talbot Rd S
Ste 500
Renton, WA 98055
Phone (425) 251-5110

4011 Talbot Rd S
Ste 500
Renton, WA 98055
Phone (425) 251-5110

Interoperability endpoints

  • Direct secure messaging: rkim18044@direct.valleymed.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1679673669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59028",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980582028",
            "telephone_number": "425-251-5110",
            "fax_number": "425-793-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S",
            "address_2": "STE 460",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-251-5110",
            "fax_number": "425-793-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RICHARD",
        "middle_name": "DONG SUK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60024762",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD60024762",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WA",
            "license": "MD60024762",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002241",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.