Individual provider Active NPI

Joe Young Kim, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Yakima, WA
National Provider Identifier
1750333233
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD6458807 Issued in WA
Practice address
1460 N. 16TH Ave., Suite D
Water'S Edge
Yakima, WA 98902
Phone
(509) 574-3805
Fax
(509) 574-3806
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 20625 MS
Pain Medicine (Anesthesiology) Physician 207LP2900X MD6458807 WA Primary

Addresses

Primary practice location

1460 N. 16TH Ave., Suite D
Water'S Edge
Yakima, WA 98902

Mailing address

1460 N 16TH Ave Ste D
Yakima, WA 98902-7102
Phone (509) 574-3805

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140821000531 WA Practitioner - Pain Management 3476564592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

1460 N 16TH Ave
Suite D
Yakima, WA 98902-7102
Phone (509) 574-3805

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6458807WAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Oct 1, 2014 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Oct 1, 2014 Accepting new patients
Yakima Valley Memorial Physicians PastSince Aug 2, 2020 Accepting new patients

Locations

1460 N 16th Ave
Ste D
Yakima, WA 98902
Phone (509) 574-3805

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Interoperability endpoints

  • Direct secure messaging: jkim772601@direct.multicare.org

Organizations & group practices 3

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 1

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1750333233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE STE D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-574-3805",
            "fax_number": "509-574-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N. 16TH AVE., SUITE D",
            "address_2": "WATER'S EDGE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-574-3805",
            "fax_number": "509-574-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOE",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MS",
            "license": "20625",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "MD6458807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.