TIFFANY KIM (O.D.) – Optometrist, NPI 1467704791

TIFFANY KIM (O.D.) is a healthcare provider. based in Portland, Oregon. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 3607ATI (OR). The NPI Number for TIFFANY KIM (O.D.) is 1467704791

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY KIM (O.D.)
NPI
1467704791
Phone
(408) 805-0354
Address
10480 SW EASTRIDGE ST APT 37
Enumeration Date
10 October 2012
Last Update Date
23 September 2015

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
2533560029
Graduation Year
2015 (11 years ago)
PAC ID
6305157843
Professional Enrollment ID
I20170303001948
Address ID
WA984097258TA4502XSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:13State licenses:1Digital endpointsOther names

672 OPTOMETRY in OR

Provider Addresses for TIFFANY KIM (O.D.)

  • 10480 SW EASTRIDGE ST APT 37

    PORTLAND, OR 972255042

    Phone: (408) 805-0354

    Type: Location

  • 25699 SW ARGYLE AVE A

    LENZA EYE CENTER

    WILSONVILLE, OR 970705798

    Phone: (503) 833-2662

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 32 Open Payments records for all available years, with a total value of $700.

Total Amount is formed as General ($700) + Research ($0) + Ownership ($0) = $700.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($397).

Total Amount

$700

General + Research + Ownership

Payments

32

Total payment records

General Amount

$700

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

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: 2017-03-03

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170303001948IOptometryWATBD

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
92014Established patient complete exam of visual system120120$0
92250Photography of the retina118111$0
99213Established patient office or other outpatient visit, 20-29 minutes11743$0
92004New patient complete exam of visual system6767$0
68761Closure of tear duct opening using plug4712$0
View full utilization report →

Insurance plans in this area (ZIP 97225)

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Reviews

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Frequently asked questions

What is TIFFANY KIM (O.D.)'s NPI number?
TIFFANY KIM (O.D.)'s NPI is 1467704791 — the number used across U.S. healthcare to identify this provider.
Is TIFFANY KIM (O.D.) still an active registrant?
TIFFANY KIM (O.D.) carries an active NPI according to the public dataset.
How would a patient describe TIFFANY KIM (O.D.)'s focus?
For TIFFANY KIM (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is TIFFANY KIM (O.D.) located near Portland?
TIFFANY KIM (O.D.) currently maps to Portland, Oregon in this extract.
Can I trust this NPI listing for TIFFANY KIM (O.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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