Kathy Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3950 Issued in WA

Practice address

8520 Steilacoom Blvd SW Ste 200a
Lakewood, WA 98498-4773

Phone

(253) 475-3937

Fax

(253) 201-2348

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Kathy Kim OD & Associates, PLLC

  • Optometrist
  • Lakewood, WA
  • NPI 1902850308
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1962591396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8520 STEILACOOM BLVD SW STE 200A",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984984773",
            "telephone_number": "253-475-3937",
            "fax_number": "253-201-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8520 STEILACOOM BLVD SW STE 200A",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984984773",
            "telephone_number": "253-475-3937",
            "fax_number": "253-201-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KATHY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "050612108",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "050612108",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030831",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "050612108",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM",
            "identifier": "050612108",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5814065",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARCH VISION CARE",
            "identifier": "#KIM",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "9659KI",
            "identifier": "REGENCE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ji S Kim
• Jooeun Kim
• Joy Kim, D.D.S
• Jungmi Kim
• Jungmin Judy Kim
• Kevin Kim, DDS
• Kyong Ho Kim, DO
• Meilani Kim, OT
• Nayeon Kim, FNP
• Sarah Jisun Kim, PHARMD

• Optometrist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.