DR. SANG WON DACRI-KIM (DO) – Vascular Surgery Physician, NPI 1043385529
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,600 GENERAL SURGERY in OH
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Provider Addresses for DR. SANG WON DACRI-KIM (DO)
1970, Tamarack Road, Newark, Licking County, Ohio, 43055, United States
NEWARK, OH 43055
Phone: (740) 344-2452
Fax: (740) 522-7305
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $352.
Total Amount is formed as General ($352) + Research ($0) + Ownership ($0) = $352.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Medtronic, Inc. ($44).
Total Amount
$352
General + Research + Ownership
Payments
18
Total payment records
General Amount
$352
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-09-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20040920001332 | I | Vascular Surgery | OH | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 256 | 46 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 171 | 116 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 83 | 72 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 72 | 29 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 72 | 72 | $0 |
Insurance plans in this area (ZIP 43055)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| VASCULAR SURGERY | OH | 11042 | Removal of skin and tissue first 20 sq cm or less | 377 | 75 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hematology/Oncology, Internal Medicine | OH | |
| Family Practice | OH | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | OH | |
| Family Practice | OH | |
| P O D I A T R Y | OH | |
| Pain Management | OH | |
| Family Practice | OH | |
| Nurse Practitioner | OH | |
| - | PA | |
| P S Y C H I A T R Y | PA |
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