TAELIM KIM (MD) – Family Medicine Physician, NPI 1811564057

TAELIM KIM (MD) is a healthcare provider. based in Portland, Oregon. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 0116035317 (VA). The NPI Number for TAELIM KIM (MD) is 1811564057

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
TAELIM KIM (MD)
NPI
1811564057
Phone
(503) 215-6494
Address
PO BOX 3158
Enumeration Date
7 June 2021
Last Update Date
30 September 2024

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
5035822100
Graduation Year
2021 (5 years ago)
PAC ID
4587066899
Group Practice PAC ID
0648183608
Professional Enrollment ID
I20240813002232
Address ID
OR970708486WI29345EXXX601
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

2,083 FAMILY PRACTICE in OR

Provider Addresses for TAELIM KIM (MD)

  • PO BOX 3158

    PORTLAND, OR 972083158

    Phone: (503) 215-6494

    Type: Mailing

  • 29345 SW TOWN CENTER LOOP E STE 110

    WILSONVILLE, OR 970708486

    Phone: (503) 582-2100

    Type: Location

  • 3650 JOSEPH SIEWICK DR STE 400

    FAIRFAX, VA 220331715

    Phone: (703) 391-2020

    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: 2024-08-13

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
I20240813002232IFamily PracticeORTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97208)

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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: 0648183608View full group profile
NameSpecialtyState
Internal MedicineOR
Physician AssistantOR
-OR
N E U R O L O G YOR
Nurse PractitionerOR
Infectious Disease, Internal MedicineOR
Thoracic SurgeryOR
Nurse PractitionerOR
Physician AssistantWA
Clinical PsychologistOR

Reviews

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No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What NPI should I save for TAELIM KIM (MD)?
Save NPI 1811564057 if you need a stable reference for TAELIM KIM (MD).
Is TAELIM KIM (MD) active in the national directory?
TAELIM KIM (MD)'s public NPI profile is in an active state.
Can you summarize TAELIM KIM (MD)'s specialty in plain language?
Clinically, the directory lists TAELIM KIM (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place TAELIM KIM (MD)?
The snapshot lists Portland, Oregon for TAELIM KIM (MD); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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