PACIFIC PAIN SPECIALISTS
NPI 1205163771
Anesthesiology - Pain Medicine in Issaquan, WA

Q: What is Pacific Pain Specialists's NPI number?

The NPI number for Pacific Pain Specialists is 1205163771. It was assigned to this organization in the NPPES registry on November 4, 2009.

Q: What is Pacific Pain Specialists's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Active since November 04, 2009CLIA 50D2008665 · Waiver

22510 SE 64TH PLACE, SUITE 120, ISSAQUAN, WA 98027(425) 391-2722(425) 391-2922 Get Directions Write a Review

NPPES record last updated: September 21, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Pacific Pain Specialists NPPES

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

PACIFIC PAIN SPECIALISTS (NPI 1205163771) is a healthcare organization registered as a pain medicine in Issaquan, Washington and active in the NPI registry since November 2009. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Jason Kim, Owner/manager, as its authorized official.

NPPES Registry Identity

NPI1205163771

Entity TypeOrganization

Primary Taxonomy207LP2900X

Legal Business NamePACIFIC PAIN SPECIALISTS

Location Address22510 SE 64TH PLACE, SUITE 120Issaquan, WA 98027

Mailing Address22510 Se 64th Place, Suite 120Issaquan, WA 98027 · (425) 391-2722 · Fax (425) 391-2922

Phone(425) 391-2722

Fax(425) 391-2922

Organization SubpartNo

Authorized OfficialJason KimOwner/manager · (206) 601-2097

Enumeration DateNovember 4, 2009

Last NPPES UpdateSeptember 21, 2010

✔ NPI 1205163771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207LP2900X

License✔ Licensed in WA · MD 00047320

Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

22510 SE 64TH PLACE, Issaquan, WA 98027

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pacific Pain Specialists is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pacific Pain Specialists, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jason Kim, MD

Pain Management

NPI 1265534036

22510 SE 64TH PL SUITE 120
Issaquah, WA 98027

(425) 391-2722

✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2008665

Pacific Pain Specialists PLLC · Issaquah, WA

Active · expires Apr 4, 2028

CLIA Number50D2008665

Laboratory TypePhysician Office

Certificate Effective DateJune 15, 2010

Certificate Expiration DateApril 4, 2028

Laboratory DirectorJason Kim

Laboratory Phone(425) 391-2722

Laboratory LocationPacific Pain Specialists PLLC1301 4th Ave NW, Issaquah, WA 98027

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Pacific Pain Specialists's NPI number?

The NPI number for Pacific Pain Specialists is 1205163771. It was assigned to this organization in the NPPES registry on November 4, 2009.

Where is Pacific Pain Specialists located?

Pacific Pain Specialists is located at 22510 SE 64th Place Suite 120, Issaquan, WA 98027. The listed phone number is (425) 391-2722.

What is Pacific Pain Specialists's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Is Pacific Pain Specialists enrolled in Medicare?

Yes. Pacific Pain Specialists is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pacific Pain Specialists?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pain Management) reassigns their Medicare billing to Pacific Pain Specialists. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pacific Pain Specialists hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2008665) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pacific Pain Specialists accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Pacific Pain Specialists 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 Pacific Pain Specialists was last updated on September 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.