Active NPI
Chanhyeok Kim
- Physician Assistant
- Vienna, VA
National Provider Identifier
1801740113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2726 Gallows Rd Apt 1001
Vienna, VA 22180-7151 - Phone
- (303) 350-7408
- NPI assigned
- Feb 24, 2026
- Last updated
- Feb 24, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
2726 Gallows Rd Apt 1001
Vienna, VA 22180-7151
Mailing address
2726 Gallows Rd Apt 1001
Vienna, VA 22180-7151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- George Washington University School of Medicine, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1109 Flor LN
Mc Lean, VA 22102-1737
2079 Daniel Stuart SQ
Woodbridge, VA 22191-3317
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771891200000",
"number": "1801740113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2726 GALLOWS RD APT 1001",
"city": "VIENNA",
"state": "VA",
"postal_code": "221807151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2726 GALLOWS RD APT 1001",
"city": "VIENNA",
"state": "VA",
"postal_code": "221807151",
"telephone_number": "303-350-7408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHANHYEOK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-02-24",
"last_updated": "2026-02-24",
"certification_date": "2026-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.