KYONG HO KIM (DO) – Interventional Pain Medicine Physician, NPI 1124009303
Interventional Pain Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
58 INTERVENTIONAL PAIN MANAGEMENT in WA
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Provider Addresses for KYONG HO KIM (DO)
11306, Bridgeport Way Southwest, Tahitian Apartments, Lakeview, Lakewood, Pierce County, Washington, 98499, United States
SUITE D
LAKEWOOD, WA 984993037
Phone: (253) 983-9390
Fax: (253) 983-0066
Type: Location
155 Lilly Rd NE Ste B
Olympia, WA 985065028
Phone: (206) 538-6300
Fax: (206) 538-6301
Type: Location
PO BOX 39324
LAKEWOOD, WA 984963324
Phone: (253) 983-9390
Fax: (253) 983-0066
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 100 Open Payments records for all available years, with a total value of $4,786.
Total Amount is formed as General ($4,786) + Research ($0) + Ownership ($0) = $4,786.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Relievant Medsystems, Inc. ($1,414).
Total Amount
$4,786
General + Research + Ownership
Payments
100
Total payment records
General Amount
$4,786
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Relievant Medsystems, Inc. | $1,414 |
| Nevro Corp. | $865 |
| Medtronic, Inc. | $406 |
| Saluda Medical Americas, Inc. | $301 |
| Boston Scientific Corporation | $188 |
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: 2004-02-04
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 |
|---|---|---|---|---|
| I20040204000336 | I | Interventional Pain Management | WA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,887 | 449 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 1,777 | 128 | $0 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 496 | 154 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 151 | 95 | $0 |
| 80307 | Testing for presence of drug, by chemistry analyzers | 106 | 86 | $0 |
Insurance plans in this area (ZIP 98499)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERVENTIONAL PAIN MANAGEMENT | WA | 20610 | Aspiration and/or injection of large joint or joint capsule | 33 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Pain Management, Anesthesiology | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| Physical Therapist In Private Practice | OR | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| Pain Management, Anesthesiology | WA | |
| Physician Assistant | OR | |
| Physician Assistant | OR |
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