NPIMap

Individual provider Active NPI

Theodore Y Kim, D.O.

  • Hematology & Oncology Physician
  • Anchorage, AK
National Provider Identifier
1952325359
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
129714 Issued in AK
Practice address
3851 Piper St Ste U340
Anchorage, AK 99508-6904
Phone
(907) 562-0321
Fax
(907) 562-0321
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 129714 AK Primary

Addresses

Primary practice location

3851 Piper St Ste U340
Anchorage, AK 99508-6904

Mailing address

PO Box 74900
Chicago, IL 60675-4900
Phone (907) 562-0321

Other practice location 1

12001 Business Blvd Ste 3C
Eagle River, AK 99577-7743
Phone (907) 562-0321

Other identifiers 3

IdentifierTypeStateIssuer
Q00801068OtherAKRAILROAD MEDICARE
1686607MedicaidAK
K169302OtherAKMEDICARE PTAN

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
I20180514000783 AK Practitioner - Medical Oncology 1254338767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
West Virginia School of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Katmai Oncology Group LLCGroup PAC ID 3072400498, 11 clinicians

Practice addresses (Care Compare)

3851 Piper St
Suite U340
Anchorage, AK 99508-6904
Phone (907) 562-0321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.97 of 100Reported as group
Quality
78.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Merit-based Incentive Payment System (MIPS)

Final score
76.58 of 100Reported as group
Quality
74.05
Improvement activities
40
Cost
56.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129714AKMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Katmai Oncology Group, LLC Hematology & Oncology CurrentSince May 2, 2018 Accepting new patients
Katmai Oncology Group, LLC Specialist CurrentSince May 2, 2018 Accepting new patients
Skagit Hospice Services, LLC Past Accepting new patients

Locations

3851 Piper St
Ste U340
Anchorage, AK 99508
Phone (907) 562-0321

12001 Business Blvd
Ste 3C
Eagle River, AK 99577
Phone (907) 562-0321

Interoperability endpoints

  • Direct secure messaging: theodore.kim@katmai.ikm.direct-ci.com

Organizations & group practices 3

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 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1952325359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606754900",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST STE U340",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995086904",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12001 Business Blvd Ste 3C",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995777743",
            "country_code": "US",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-2683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "THEODORE",
        "middle_name": "Y",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AK",
            "license": "129714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00801068",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1686607",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K169302",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.