NPIMap

Individual provider Active NPI

Byung Kyu Kim, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tukwila, WA
National Provider Identifier
1932402377
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD60265716 Issued in WA
Practice address
12501 E Marginal Way S Ste 200
Tukwila, WA 98168-5163
Phone
(206) 576-6050
NPI assigned
Dec 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X MD60265716 WA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD60265716 WA Primary

Addresses

Primary practice location

12501 E Marginal Way S Ste 200
Tukwila, WA 98168-5163

Mailing address

1124 Columbia St Ste 200
Seattle, WA 98104-2048
Phone (206) 576-6145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171003007702 WA Practitioner - Pathology 0648545590 Reassigns benefits to 2 organizations
I20241011000805 AK Practitioner - Pathology 0648545590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cellnetix Pathology PLLCGroup PAC ID 8224062971, shared by 3 NPIs, 58 clinicians

Practice addresses (Care Compare)

1124 Columbia St
Suite 200
Seattle, WA 98104-2048
Phone (206) 386-2676

2490 S Woodworth Loop
Suite 410
Palmer, AK 99645-7411
Phone (807) 745-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60265716WAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC CurrentSince May 31, 2018 Accepting new patients
Cellnetix Pathology, PLLC Cytopathology CurrentSince Oct 14, 2017 Accepting new patients
Cellnetix Pathology, PLLC Cytopathology CurrentSince Aug 13, 2024 Accepting new patients
Cellnetix Pathology, PLLC Cytopathology Current Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Oct 14, 2017 Accepting new patients
The Polyclinic PLLC CurrentSince May 31, 2018 Accepting new patients

Locations

2490 S Woodworth Loop
Ste 410
Palmer, AK 99645
Phone (807) 745-8100

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

1124 Columbia St
Ste 200
Seattle, WA 98104
Phone (206) 576-6050

1145 Broadway
Seattle, WA 98122

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

12501 E Marginal Way S
Ste 200
Tukwila, WA 98168
Phone (206) 576-6050

Organizations & group practices 6

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 5

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": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1932402377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 COLUMBIA ST STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042048",
            "telephone_number": "206-576-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 E MARGINAL WAY S STE 200",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685163",
            "telephone_number": "206-576-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BYUNG",
        "middle_name": "KYU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "WA",
            "license": "MD60265716",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD60265716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

Verify at the official NPI Registry.