Robert Dong Kim, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

48138 Issued in WI

Practice address

9427 SW Barnes Rd Ste 296
Portland, OR 97225-6667

Phone

(503) 297-3778

Fax

(503) 297-7853

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

University of Wisconsin School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
• Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment NPD
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Legacy Meridian Park Hospital

  • Hospitalist Physician
  • Tualatin, OR
  • NPI 1023305034
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Lutheran Charities

  dba Columbia Memorial Hospital

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1134146939
  Care Compare affiliation
• Columbia Lutheran Charities

  dba CMH Cardiology Clinic

  • Cardiovascular Disease Physician
  • Astoria, OR
  • NPI 1629378880

  Hospital

  Care Compare affiliation
• Columbia Lutheran Charities

  • Critical Access Hospital
  • Astoria, OR
  • NPI 1700809761
  Care Compare affiliation
• Columbia Lutheran Charities

  dba Columbia Memorial Hospital

  • Surgery Physician
  • Astoria, OR
  • NPI 1821254129

  Hospital

  Care Compare affiliation
• Columbia Lutheran Charities

  • Surgery Physician
  • Astoria, OR
  • NPI 1871747659

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  dba Legacy Good Samaritan Providers

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Care Compare affiliation

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1780620096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE",
            "address_2": "SUITE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322684",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD STE 296",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256667",
            "telephone_number": "503-297-3778",
            "fax_number": "503-297-7853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19250 SW 65th Ave Ste 135",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627745",
            "country_code": "US",
            "telephone_number": "503-692-8560",
            "fax_number": "503-692-8562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16770 SW Edy Rd Ste 216",
            "address_purpose": "LOCATION",
            "city": "Sherwood",
            "state": "OR",
            "postal_code": "971409679",
            "country_code": "US",
            "telephone_number": "503-297-3778",
            "fax_number": "503-297-7853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "879 Providence Dr",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971327563",
            "country_code": "US",
            "telephone_number": "503-297-3778",
            "fax_number": "503-297-7853",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ROBERT",
        "middle_name": "DONG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WI",
            "license": "48138",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD126279",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD126279",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017147",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500609710",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nam Hoon Kim, D.C.
• Nicole J Kim
• Olivia Kim, PHARMD
• Olivia Kim
• Rachel Haesu Kim, DMD
• SE-Jin Kim
• Sean Yoontae Kim, DO
• Shane Christopher Kim, MD
• Shane K. Kim, MD
• Sharon Bokyong Kim, M.D.

• Critical Care Medicine (Internal Medicine) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Critical Care Medicine (Internal Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.