Individual provider Active NPI

Kevin Kim

  • Internal Medicine Physician
  • Federal Way, WA
National Provider Identifier
1922428952
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60941703 Issued in WA
Practice address
33501 1St Way S
Federal Way, WA 98003-6208
Phone
(253) 838-2400
Fax
(253) 874-1637
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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 A138163 CA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD60941703 WA Primary

Addresses

Primary practice location

33501 1St Way S
Federal Way, WA 98003-6208

Mailing address

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190725003323 WA Practitioner - Internal Medicine 7618245432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

Hospital & facility affiliations

  • Haven Home Health Care Home health agency, Federal Way, WA, CCN 507132
  • Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138163CAMDClinical Social Worker
A138163CAMDInternal Medicine Physician
MD60941703WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Aug 8, 2019 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Family Medicine CurrentSince Aug 8, 2019 Accepting new patients
Virginia Mason Medical Center Past Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

33501 1st Way S
Federal Way, WA 98003
Phone (253) 838-2400

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/

Organizations & group practices 4

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 2

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1922428952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33501 1ST WAY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036208",
            "telephone_number": "253-838-2400",
            "fax_number": "253-874-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33501 1ST WAY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036208",
            "telephone_number": "253-838-2400",
            "fax_number": "253-874-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A138163",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60941703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.