Michael M Kim, MD

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

MD27979 Issued in OR

Practice address

2525 NW Lovejoy St Ste 402
Portland, OR 97210-2865

Phone

(503) 575-1910

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580601600000",
    "number": "1689720468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NW LOVEJOY ST STE 402",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102865",
            "telephone_number": "503-575-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW LOVEJOY ST STE 402",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102865",
            "telephone_number": "503-575-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-02-02",
        "certification_date": "2020-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "OR",
            "license": "MD27979",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AZ",
            "license": "42031",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433505",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218503",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807968400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kwang Il Kim, MSW
• Lana Kim, PHD, LMFT
• Larry J. Kim
• Laura Jihyun Kim, MD
• Lauren Hyunhee Kim, MD
• Min a Kim, DMD
• Min Joo Kim
• Myung Sun Kim
• Nam Hoon Kim, D.C.
• Nicole J Kim

• Facial Plastic Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Facial Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.