DR. TAE WON KIM O.D.
NPI 1073946406
Optometrist in Killeen, TX

Q: What is Tae Won Kim's NPI number?

The NPI number for Tae Won Kim is 1073946406. It was assigned to this individual provider in the NPPES registry on August 21, 2013.

Q: What is Tae Won Kim's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Tae Won Kim was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 21, 2013PECOS Enrolled

2100 S W S YOUNG DR STE 1000, KILLEEN, TX 76543(254) 261-7449(254) 261-7450 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 16, 2023, Mar 22, 2023 (2 updates tracked since 2023).

On this page

About Dr. Tae Won Kim O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TAE WON KIM O.D. (NPI 1073946406) is an individual optometrist in Killeen, Texas, licensed in Texas (9128) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Harker Heights.

NPPES Registry Identity

NPI1073946406

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. TAE WON KIMCredential: O.D.

Location Address2100 S W S YOUNG DR STE 1000Killeen, TX 76543-5355

Mailing Address2100 S W S Young Dr Ste AKilleen, TX 76543-5352 · (254) 953-1164

Phone(254) 261-7449

Fax(254) 261-7450

Sole ProprietorNo

Enumeration DateAugust 21, 2013

Last NPPES UpdateMay 16, 20232 updates tracked since enumeration

NPPES CertifiedMay 16, 2023

✔ NPI 1073946406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in TX · 9128✔ Licensed in FL · OPC4831

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

2100 S W S YOUNG DR STE 1000, Killeen, TX 76543

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Secondary Practice Location 1

Location 1201 E Central Texas Expy Ste 300Harker Heights, TX 76548-2747 · Phone (254) 669-6316

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tae Won Kim O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tae Won Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jennifer C. Pacheco, O.D., P.L.L.C.

1,117 mi

Optometrist

1205 S POWERLINE RD
Pompano Beach, FL 33069

Reassigned Medicare billing, Florida enrollment
Medicare enrollment name: Jennifer C Pacheco Od PLLC
9 clinicians in this Medicare group

NPI 1417376112 (954) 977-6636

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76543 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KILLEEN VISION 153

Optometrist (Corneal and Contact Management)

2100 S W S YOUNG DR STE 1000
KILLEEN, TX 76543

Bell County (254) 261-7449

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tae Won Kim's NPI number?

The NPI number for Tae Won Kim is 1073946406. It was assigned to this individual provider in the NPPES registry on August 21, 2013.

Where is Tae Won Kim located?

Tae Won Kim practices at 2100 S W S Young Dr Ste 1000, Killeen, TX 76543. The listed phone number is (254) 261-7449.

What is Tae Won Kim's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Tae Won Kim enrolled in Medicare?

Yes. Tae Won Kim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tae Won Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tae Won Kim reassigns Medicare benefits to Jennifer C. Pacheco, O.D., P.L.L.C. (Pompano Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tae Won Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tae Won Kim accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 3 other insurers list Tae Won Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tae Won Kim was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.