KI WAN KIM (MD) – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1356490734

KI WAN KIM (MD) is a healthcare provider. based in Atlanta, Georgia. specializing in THORACIC SURGERY. They hold the professional credentials MD. They hold a License No. A90695 (CA). The NPI Number for KI WAN KIM (MD) is 1356490734

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
KI WAN KIM (MD)
NPI
1356490734
Phone
(770) 424-9732
Address
315 Boulevard NE Ste 500
Enumeration Date
9 January 2007
Last Update Date
16 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7704248222
Graduation Year
2003 (23 years ago)
PAC ID
5193993145
Group Practice PAC ID
6709065402
Professional Enrollment ID
I20190624003454
Address ID
GA301527742KE5150XRDXX501
Telehealth
Yes

Contacts

Secure Messaging
kkim339773@directwellstar.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience75
Completeness85
Years active:19State licenses:3Other namesUpdated within 12 months

155 THORACIC SURGERY in GA

Provider Addresses for KI WAN KIM (MD)

  • 315 Boulevard NE Ste 500

    Atlanta, GA 30312

    Phone: (770) 424-9732

    Type: Location

  • 2650 Ridge Ave

    Walgreen Building Suite 3507

    Evanston, IL 602011718

    Phone: (847) 570-2868

    Type: Location

  • 61 WHITCHER ST NE STE 4120

    MARIETTA, GA 30060

    Phone: (770) 424-9732

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 81 Open Payments records for all available years, with a total value of $2,221.

Total Amount is formed as General ($2,221) + Research ($0) + Ownership ($0) = $2,221.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($244).

Total Amount

$2,221

General + Research + Ownership

Payments

81

Total payment records

General Amount

$2,221

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-06-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110719000644IThoracic SurgeryILTBD
I20190624003454IThoracic SurgeryGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99205New patient office or other outpatient visit, 60-74 minutes4545$0
99443Telephone medical discussion with physician, 21-30 minutes3129$0
32674Removal of lymph nodes of chest cavity using an endoscope1818$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes1313$0
32652Removal of chest cavity lining and lung lining using an endoscope1212$0
View full utilization report →

Insurance plans in this area (ZIP 30312)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709065402View full group profile
NameSpecialtyState
-GA
-GA
-GA
R H E U M A T O L O G YMI
Hospitalist, Internal MedicineGA
Nurse PractitionerTN
Family PracticeGA
Physician AssistantGA
Physician AssistantGA
Hospitalist, Internal MedicineGA

Reviews

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Frequently asked questions

Can I use this page to confirm KI WAN KIM (MD)'s NPI?
Yes. KI WAN KIM (MD) is listed with NPI 1356490734 in the public NPI dataset.
Does the file indicate KI WAN KIM (MD) is practicing under active NPI?
Directory data currently reports KI WAN KIM (MD) as active.
What is KI WAN KIM (MD)'s specialty?
The listing groups KI WAN KIM (MD) with Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. Clinical services aligned with this taxonomy classification.
Does KI WAN KIM (MD) list a practice location?
Patients near Atlanta, Georgia may find KI WAN KIM (MD) in results; validate coverage separately.
Why does KI WAN KIM (MD) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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