NPIMap

Individual provider Active NPI

Doug Shin Kim, MD

  • Family Medicine Physician
  • Federal Way, WA
National Provider Identifier
1720087067
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00027275 Issued in WA
Practice address
31830 Pacific Hwy S Ste D
Federal Way, WA 98003-5449
Phone
(253) 941-7100
Fax
(253) 941-1510
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00027275 WA Primary

Addresses

Primary practice location

31830 Pacific Hwy S Ste D
Federal Way, WA 98003-5449

Mailing address

31830 Pacific Hwy S Ste D
Federal Way, WA 98003-5449
Phone (253) 941-7100

Other identifiers 4

IdentifierTypeStateIssuer
78257OtherWALABOR AND INDUSTRIES ID
1302280MedicaidWA
KI2297OtherWAREGENCE PROVIDER ID #
911891770OtherWATAX IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20060306000675 WA Practitioner - Family Practice 5092721605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sound Medical Center IncGroup PAC ID 7315953916, 2 clinicians

Practice addresses (Care Compare)

31830 Pacific Hwy S
Suite D
Federal Way, WA 98003-5449
Phone (253) 941-7100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Medical Center Inc Family Medicine CurrentSince May 1, 2006 Accepting new patients
Westcare Clinic Inc PS Family Medicine PastSince Feb 23, 2025 Accepting new patients

Locations

31830 Pacific Hwy S
Ste D
Federal Way, WA 98003
Phone (253) 941-7100

31260 Pacific Hwy S
Ste 3
Federal Way, WA 98003
Phone (253) 941-7100

Interoperability endpoints

  • Direct secure messaging: doug.kim@973744416882692.direct.elationemr.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1720087067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31830 PACIFIC HWY S STE D",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035449",
            "telephone_number": "253-941-7100",
            "fax_number": "253-941-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31830 PACIFIC HWY S STE D",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035449",
            "telephone_number": "253-941-7100",
            "fax_number": "253-941-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DOUG",
        "middle_name": "SHIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00027275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES ID",
            "identifier": "78257",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1302280",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER ID #",
            "identifier": "KI2297",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "911891770",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.