ALLEN JI KIM (O.D.) – Optometrist, NPI 1821355587

ALLEN JI 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. 3509ATI (OR). The NPI Number for ALLEN JI KIM (O.D.) is 1821355587

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
ALLEN JI KIM (O.D.)
NPI
1821355587
Phone
(503) 493-7070
Address
3978 N WILLIAMS AVE
Enumeration Date
19 April 2012
Last Update Date
23 June 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5036101025
Graduation Year
2013 (13 years ago)
PAC ID
7315180023
Group Practice PAC ID
4385735430
Professional Enrollment ID
I20130828000539
Address ID
OR971409316SH20015HWYX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

672 OPTOMETRY in OR

Provider Addresses for ALLEN JI KIM (O.D.)

  • 3978 N WILLIAMS AVE

    PORTLAND, OR 972271445

    Phone: (503) 493-7070

    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 14 Open Payments records for all available years, with a total value of $409.

Total Amount is formed as General ($409) + Research ($0) + Ownership ($0) = $409.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: RxSight Inc ($183).

Total Amount

$409

General + Research + Ownership

Payments

14

Total payment records

General Amount

$409

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2013-08-28

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
I20130828000539IOptometryORTBD

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 97227)

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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: 4385735430View full group profile
NameSpecialtyState
O P T O M E T R YOR
-OR
O P H T H A L M O L O G YCA
O P H T H A L M O L O G YOR
O P T O M E T R YOR

Reviews

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Frequently asked questions

Can I cross-check ALLEN JI KIM (O.D.) using NPI 1821355587?
NPI 1821355587 belongs to ALLEN JI KIM (O.D.); compare other details if you need extra assurance.
Is there an active status for ALLEN JI KIM (O.D.)?
For scheduling context, ALLEN JI KIM (O.D.) is shown as active in the registry.
What area of care is associated with ALLEN JI KIM (O.D.)?
ALLEN JI KIM (O.D.)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Is ALLEN JI KIM (O.D.) located near Portland?
ALLEN JI KIM (O.D.) currently maps to Portland, Oregon in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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