Active NPI
Isaac Kihoon Kim, MD
- Internal Medicine Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD191584
- Practice address
- 4805 NE Glisan St
Portland, OR 97213-2933 - Phone
- (503) 215-2392
- NPI assigned
- May 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PG177300 | OR | |
| Internal Medicine Physician | 207R00000X | MD191584 | OR | Primary |
Addresses
Primary practice location
4805 NE Glisan St
Portland, OR 97213-2933
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other practice location 1
5050 NE Hoyt St
Ste 540
Portland, OR 97213-2991
Phone (503) 215-6600
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ikim600369@oc.providencedirect.org | ||
| Direct Messaging Address | ikim600369@oc.providencedirect.org | ||
| Direct Messaging Address | ikim600369@oc.providencedirect.org | ||
| Direct Messaging Address | ikim600369@oc.providencedirect.org | ||
| Direct Messaging Address | ikim600369@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Loma Linda University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone (503) 513-3613
4805 NE Glisan St
Portland, OR 97213-2933
5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480
9290 SE Sunnybrook Blvd
Suite 120
Clackamas, OR 97015-6802
Phone (503) 215-2110
Hospital & facility affiliations
- Providence Portland Medical Center
- Providence Seaside Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Internal Medicine | Current | Accepting new patients |
| Providence Health & Services Oregon | Internal Medicine | Current | Accepting new patients |
Locations
9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960
810 12th St
Hood River, OR 97031
Phone (541) 386-3911
1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250
1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661
1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538
1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631
4805 NE Glisan St
Ste BG5
Portland, OR 97213
Phone (503) 215-2392
10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202
5050 NE Hoyt St
Ste 540
Portland, OR 97213
Phone (503) 215-6600
1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250
4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111
5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480
Interoperability endpoints
- ikim600369@oc.providencedirect.org
Organizations & group practices 11
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.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
Internal Medicine
-
- General Practice Physician
- Lake Oswego, OR
- NPI 1023488343
-
- Clinic/Center
- Medford, OR
- NPI 1093976243
-
- Clinical Pathology Physician
- Hood River, OR
- NPI 1053862714
Internal Medicine
-
- Otolaryngology Physician
- The Dalles, OR
- NPI 1083963573
-
- Clinical Pathology Physician
- Medford, OR
- NPI 1285185942
Internal Medicine
-
- General Acute Care Hospital
- Medford, OR
- NPI 1689755670
Internal Medicine
-
- Clinical Pathology Physician
- Portland, OR
- NPI 1740732650
Internal Medicine
-
- Rural Health Clinic/Center
- Hood River, OR
- NPI 1073100095
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Portland, OR
- NPI 1396818993
-
- Psychiatry Physician
- Portland, OR
- NPI 1760177737
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
-
- Critical Access Hospital
- Seaside, OR
- NPI 1578500492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1801243530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132933",
"telephone_number": "503-215-2392"
}
],
"practiceLocations": [
{
"address_1": "5050 NE Hoyt St",
"address_2": "STE 540",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972132991",
"country_code": "US",
"telephone_number": "503-215-6600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "ISAAC",
"middle_name": "KIHOON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-23",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OR",
"license": "PG177300",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD191584",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ikim600369@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1001 N Providence Dr",
"city": "Newberg",
"state": "OR",
"country_code": "US",
"postal_code": "971327485",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ikim600369@oc.providencedirect.org",
"affiliation": "N",
"address_1": "10150 SE 32nd Ave",
"city": "Milwaukie",
"state": "OR",
"country_code": "US",
"postal_code": "972226516",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ikim600369@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1111 Crater Lake Ave",
"city": "Medford",
"state": "OR",
"country_code": "US",
"postal_code": "975046241",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ikim600369@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1500 Division St",
"city": "Oregon City",
"state": "OR",
"country_code": "US",
"postal_code": "970451527",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ikim600369@oc.providencedirect.org",
"affiliation": "N",
"address_1": "4805 NE Glisan St Ste Bg05",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972132933",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.