MICHELLE HEESUNG KIM
NPI 1104467620
Nurse Practitioner - Family in Oklahoma City, OK
About Michelle Heesung Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHELLE HEESUNG KIM (NPI 1104467620) is an individual family provider in Oklahoma City, Oklahoma, licensed in Washington (AP61045635) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Michelle Heesung Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Michelle Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Renton, WA 98055
- Reassigned Medicare billing, Washington enrollment
- 10 clinicians in this Medicare group
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 73109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
OKLAHOMA CITY, OK 73109
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 Michelle Kim's NPI number?
The NPI number for Michelle Kim is 1104467620. It was assigned to this individual provider in the NPPES registry on October 6, 2019.
Where is Michelle Kim located?
Michelle Kim practices at 4401 S Western Ave, Oklahoma City, OK 73109. The listed phone number is (405) 636-7000.
What is Michelle Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Michelle Kim enrolled in Medicare?
Yes. Michelle Kim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Michelle Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Kim reassigns Medicare benefits to Westcare Clinic Inc Ps (Renton, WA). 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 Michelle Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Michelle Kim accept?
Health plans from Ambetter from Arizona Complete Health and Premera Blue Cross Blue Shield of Alaska list Michelle 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 Michelle Kim was last updated on January 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Michelle Heesung Kim · NPI 1104467620
Family physician in Oklahoma City, Oklahoma. Individual provider, active in the CMS NPPES registry since October 6, 2019.
## Identity
- **NPI:** 1104467620 (Entity type: Individual)
- **Enumerated:** October 6, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** AP61045635 (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4401 S WESTERN AVE, Oklahoma City, OK 73109-3413
- **Phone:** (405) 636-7000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Westcare Clinic Inc Ps (NPI 1881769552, Renton, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 7, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104467620) · Data from the CMS NPPES public registry.