NPIMap

Individual provider Active NPI

Kwanghee Kim, MD

  • Internal Medicine Physician
  • Anchorage, AK
National Provider Identifier
1851621064
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MEDS7869 Issued in AK
Practice address
3300 Providence Dr
Tower B, Suite 314
Anchorage, AK 99508
Phone
(907) 212-3420
NPI assigned
Jan 11, 2010
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11726 ND
Internal Medicine Physician 207R00000X 258429 NY
Internal Medicine Physician 207R00000X MEDS7869 AK Primary

Addresses

Primary practice location

3300 Providence Dr
Tower B, Suite 314
Anchorage, AK 99508

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20131112001401 AK Practitioner - Internal Medicine 7719166073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Eagle River, AK 99577-8078
Phone (907) 694-8085

3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 562-2211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MEDS7869AKMDInternal Medicine Physician
11726NDMDInternal Medicine Physician
258429NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Sep 12, 2013 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

3300 Providence Dr
Ste B314
Anchorage, AK 99508

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1851621064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PROVIDENCE DR",
            "address_2": "TOWER B, SUITE 314",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99508",
            "telephone_number": "907-212-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KWANGHEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-11",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "11726",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "258429",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "MEDS7869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.