OLYMPIA SURGERY CENTER – Specialist, NPI 1487669305

OLYMPIA SURGERY CENTER is a healthcare provider. based in Olympia, Washington. specializing in Specialist. The NPI Number for OLYMPIA SURGERY CENTER is 1487669305

Main info

Organization
Name
OLYMPIA SURGERY CENTER
NPI
1487669305
Phone
(360) 357-6314
Address
128 LILLY RD NE STE 202
Authorized Official
DR. SUNG-WON KIM OWNER/PARTNER M.D.
Enumeration Date
29 July 2006
Last Update Date
15 June 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for OLYMPIA SURGERY CENTER

  • 202, Lilly Road Northeast, Olympia, Thurston County, Washington, 98506, United States

    OLYMPIA, WA 985065029

    Phone: (360) 357-6314

    Fax: (360) 705-3745

    Type: Location

  • 128 LILLY RD NE STE 101

    OLYMPIA, WA 985067400

    Phone: (360) 634-4070

    Fax: (360) 634-4071

    Type: Location

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: 2023-10-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1046 days ago).

Enrollment records

2

Earliest due date

2023-07-31

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
O20031226000116OClinic/Group PracticeWA2023-07-31
O20231031000589OAmbulatory Surgical CenterWATBD

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 98506)

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Reviews

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Frequently asked questions

What is the registry number for OLYMPIA SURGERY CENTER?
The registry entry for OLYMPIA SURGERY CENTER shows NPI 1487669305.
Does the public listing show OLYMPIA SURGERY CENTER as active?
OLYMPIA SURGERY CENTER's NPI record reflects an active status in NPPES.
How should patients interpret OLYMPIA SURGERY CENTER's specialty?
The extract shows Other Service Providers for OLYMPIA SURGERY CENTER. Clinical services aligned with this taxonomy classification.
What geographic area is tied to OLYMPIA SURGERY CENTER?
OLYMPIA SURGERY CENTER is associated with Olympia, Washington in the same public data insurers reference.
Who maintains OLYMPIA SURGERY CENTER's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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