Amanda Jane Wong Kim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60845015 Issued in WA

Practice address

3915 Talbot Rd S Ste 401
Renton, WA 98055-5738

Phone

(425) 690-3445

NPI assigned

Apr 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Amanda Wong Former name

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

Specialty

Family Practice

Education

University of Maryland School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Medical Center Hospital, Renton, WA, CCN 500088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akim81314@direct.valleymed.org

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.

• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Public Hospital District #1 of King County

  • Rehabilitation Hospital Unit
  • Renton, WA
  • NPI 1811063308
  NPD (past)
• Public Hospital District 1 of King County

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230
  NPD (past)

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

• Public Hospital District 1 of King County

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230
  Care Compare affiliation
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Care Compare affiliation

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1992192579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S STE 401",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-690-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S STE 401",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-690-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "995 Potrero Ave Bldg 80-3",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941102859",
            "country_code": "US",
            "telephone_number": "415-206-5252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Potrero Ave",
            "address_2": "Bldg 80-83",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941103518",
            "country_code": "US",
            "telephone_number": "415-206-8611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "995 Potrero Ave Bldg 80-3",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941102859",
            "country_code": "US",
            "telephone_number": "415-206-5252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 Madison St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98104",
            "country_code": "US",
            "telephone_number": "206-386-6111",
            "fax_number": "206-386-6113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "AMANDA",
        "middle_name": "JANE WONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A144999",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60845015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WONG",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Kiesler, P.T.
• Elizabeth Louise Kijima, ARNP
• Zachary A Kile, PA
• Emily Ann Kilham, RD
• Kim Gon Acupuncture Clinic LLC
• Andrew Kim, PT
• Faith Kim, MSW
• Gon Kim, L.AC
• Grace Miran Kim, PHARMD
• Hyon Chong Kim, M.D.

• Family Medicine Physician in Renton, WA
• Providers in Renton, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.