Hyeongyu Kim, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202211907NP-PP Issued in OR

Practice address

5200 Meadows Rd Ste 200
Lake Oswego, OR 97035-0086

Phone

(855) 255-1750

Fax

(855) 255-0905

NPI assigned

Sep 6, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Wound Healing PSGroup PAC ID 2860794070, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• United Wound Healing PS

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Puyallup, WA
  • NPI 1669845327

  OR

  Medicare reassignment Care Compare group
• United Wound Healing Accountable Care Consultants PLLC

  • Surgery Physician
  • Puyallup, WA
  • NPI 1881337632
  NPD

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

{
    "created_epoch": "1630886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1992473706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 29TH ST NE STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983727154",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 MEADOWS RD STE 200",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970350086",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 29th St NE Ste I",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983727154",
            "country_code": "US",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYEONGYU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-06",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OR",
            "license": "201602206RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61354264",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202211907NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Kibani
• Megan B Kieres, LMT
• Peter Jonathan Kiessling, M.D.
• Alison Jane Kilcup, MD
• Paula Diane Kilpatrick
• Saebom Kim, APRN
• Kimberly J. Schleef D.O., LLC
• Paul L Kimbrel, DMD
• Stephen Robert Kimbrough, CPHT
• Hidenao Kimura, MD

• Nurse Practitioner in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.