Yi Soo Robert Kim, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD60021352 Issued in WA

Practice address

4700 Point Fosdick Dr NW
Suite 307
Gig Harbor, WA 98335-1706

Phone

(253) 857-8346

Fax

(253) 857-0259

NPI assigned

Dec 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Vascular Surgery

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Vein and Aesthetic Center PSGroup PAC ID 6608932884, 2 clinicians

Practice addresses (Care Compare)

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.

• Northwest Vein and Aesthetic Center PS

  • Legal Medicine
  • Gig Harbor, WA
  • NPI 1548409337
  Medicare reassignment Care Compare group NPD
• Mai Pham, MD PS

  • Clinic/Center
  • Edmonds, WA
  • NPI 1457694127
  Medicare reassignment NPD

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1891978128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 307",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-857-8346",
            "fax_number": "253-857-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR NW",
            "address_2": "SUITE 307",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-857-8346",
            "fax_number": "253-857-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YI SOO",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-10",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A78915",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60021352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wajahat Ali Khan, M.D.
• Michelle Kice, ARNP
• Todd Cameron Killebrew, N.D.
• Kim Rioux, DDS PLLC
• Jihyon Kim
• Heather Cuniff King, PMHNP
• Aaron Keith Kirby, LMP, MMLT
• Suzanne M Kirsch, M.S.LMFT
• Martin Asobo Kisang
• Lani Ann Kish, BS

• Vascular Surgery Physician in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Vascular Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.