KITAE KIM (MD) – Surgical Critical Care Physician, NPI 1033188289
Surgical Critical Care Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
308 GENERAL SURGERY in NV
Provider Addresses for KITAE KIM (MD)
3131 LA CANADA ST STE 217
LAS VEGAS, NV 891692579
Phone: (702) 369-7152
Fax: (702) 369-7153
Type: Mailing
10564 5th Ave NE Ste 102
Seattle, WA 981257200
Phone: (206) 508-8768
Fax: (224) 235-4652
Type: Location
3061 S MARYLAND PKWY STE 104
LAS VEGAS, NV 891096226
Phone: (702) 629-3771
Fax: (702) 438-6666
Type: Location
2657 WINDMILL PKWY # 685
HENDERSON, NV 890743384
Phone: (702) 629-3771
Fax: (702) 438-6666
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-06-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051201000096 | I | General Surgery | NV | TBD |
| I20230602001753 | I | General Surgery | AZ | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 89169)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | AZ | |
| - | AZ | |
| P O D I A T R Y | AZ | |
| Nurse Practitioner | AZ | |
| General Surgery | AZ | |
| General Surgery | AZ | |
| - | KS | |
| - | AZ | |
| Internal Medicine | NY | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | NV |
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