NPIMap

Individual provider Active NPI

Joseph Jyong Won Kim I, MD

  • Internal Medicine Physician
  • Clackamas, OR
National Provider Identifier
1891998043
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD28418 Issued in OR
Practice address
10151 SE Sunnyside Rd Ste 100
Clackamas, OR 97015-5705
Phone
(503) 659-0880
Fax
(503) 513-7425
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD28418 OR Primary

Addresses

Primary practice location

10151 SE Sunnyside Rd Ste 100
Clackamas, OR 97015-5705

Mailing address

10151 SE Sunnyside Rd Ste 100
Clackamas, OR 97015-5705
Phone (503) 659-0880

Other identifiers 1

IdentifierTypeStateIssuer
026193MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20080917000074 OR Practitioner - Internal Medicine 7113094103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nevada School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10151 SE Sunnyside Rd
Suite 100
Clackamas, OR 97015-5705
Phone (503) 659-0880

Hospital & facility affiliations

  • Adventist Health Home Care Services Home health agency, Portland, OR, CCN 387047
  • Ageright Care at Home Home health agency, Milwaukie, OR, CCN 387151
  • Adventist Health Portland Hospital, Portland, OR, CCN 380060
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28418ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center CurrentSince Mar 16, 2020 Accepting new patients
Portland Adventist Medical Center CurrentSince Jul 12, 2023 Accepting new patients
Portland Adventist Medical Center Internal Medicine CurrentSince Jul 12, 2023 Accepting new patients
Portland Adventist Medical Center Internal Medicine Current Accepting new patients
Walla Walla General Hospital Past Accepting new patients

Locations

11211 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 513-7425

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

Interoperability endpoints

  • Direct secure messaging: jkim118308@oc.providencedirect.org
  • Direct secure messaging: jkim154563@direct.ohsu.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1891998043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 SE SUNNYSIDE RD STE 100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155705",
            "telephone_number": "503-659-0880",
            "fax_number": "503-513-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 SE SUNNYSIDE RD STE 100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155705",
            "telephone_number": "503-659-0880",
            "fax_number": "503-513-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOSEPH",
        "middle_name": "JYONG WON",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD28418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026193",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.