MUSEONG KIM (NP) – Registered Nurse, NPI 1205440484

MUSEONG KIM (NP) is a healthcare provider. based in Tacoma, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. AP61449904 (WA). The NPI Number for MUSEONG KIM (NP) is 1205440484

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
MUSEONG KIM (NP)
NPI
1205440484
Phone
(253) 441-4742
Address
1148 BROADWAY STE 100
Enumeration Date
3 September 2020
Last Update Date
19 July 2023

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
2537991246
Graduation Year
2023 (3 years ago)
PAC ID
2163877382
Group Practice PAC ID
3274947304
Professional Enrollment ID
I20231009001050
Address ID
WA983749308PU10221EXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

Provider Addresses for MUSEONG KIM (NP)

  • 1148 BROADWAY STE 100

    TACOMA, WA 984023518

    Phone: (253) 441-4742

    Type: Location

  • 1959 NE PACIFIC ST

    SEATTLE, WA 981950001

    Phone: (206) 543-8736

    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: 2023-10-09

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
I20231009001050INurse PractitionerWATBD

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 98402)

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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: 3274947304View full group profile
NameSpecialtyState
Physician AssistantCA
Physician AssistantWA
Nurse PractitionerCO
Nurse PractitionerWA
Nurse PractitionerMA
Physician AssistantTN
Physician AssistantCO
Physician AssistantTX
Physician AssistantWA
Physician AssistantCO

Reviews

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Frequently asked questions

Can I verify MUSEONG KIM (NP) with an NPI only?
You can start verification with NPI 1205440484 for MUSEONG KIM (NP), then check state licensing separately.
Can I rely on MUSEONG KIM (NP) being an active provider?
As of the registry snapshot, MUSEONG KIM (NP) is marked active.
What taxonomy line describes MUSEONG KIM (NP)?
For research purposes, treat MUSEONG KIM (NP) as Registered Nurse in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for MUSEONG KIM (NP)?
MUSEONG KIM (NP)'s geographic hint is Tacoma, Washington in our summary view.
Why does MUSEONG KIM (NP) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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