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TAE HEE KIM MD
NPI 1306587332
Student in an Organized Health Care Education/Training Program in Buffalo, NY

Active since April 05, 2022PECOS EnrolledAccepts Medicare Assignment
955 MAIN ST STE 7230, BUFFALO, NY 14203(716) 829-2012 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tae Hee Kim Md NPPES

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

TAE HEE KIM MD (NPI 1306587332) is an individual student in an organized health care education/training program in Buffalo, New York and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1306587332
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameTAE HEE KIMCredential: MD
Location Address955 MAIN ST STE 7230Buffalo, NY 14203-1121
Mailing Address955 Main St Ste 7230Buffalo, NY 14203-1121
Phone(716) 829-2012
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 5, 2022
NPPES CertifiedApril 4, 2022
✔ NPI 1306587332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
955 MAIN ST STE 7230, Buffalo, NY 14203
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tae Hee Kim Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557841822
PECOS Enrollment IDI20260216002774
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 Hee Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
2,174 mi
Health Maintenance Organization
43112 N 15TH ST
Lancaster, CA 93534
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1982863783 (661) 726-2279

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

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.

SARAH KHALED ALEM
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-5076
TERRY XIA MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-2012
BAILEY MICHAEL MAJTYKA MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-2012
KEVIN ALEXANDER DIMAGNO DO
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (585) 414-9386
DR. LESTER ERNESTO BAYONA CHUYE MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-6132
ELENA BARBARA HEIDEN PETERS MD
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 645-9707
GABRIELA MARIE KLANSKY D.O.
Student in an Organized Health Care Education/Training Program
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-2012
ARSLAN INAYAT MD
Internal Medicine
955 MAIN ST STE 7230
BUFFALO, NY 14203
Erie County (716) 829-5997

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 Hee Kim's NPI number?

The NPI number for Tae Hee Kim is 1306587332. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Where is Tae Hee Kim located?

Tae Hee Kim practices at 955 Main St Ste 7230, Buffalo, NY 14203. The listed phone number is (716) 829-2012.

What is Tae Hee Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Tae Hee Kim enrolled in Medicare?

Yes. Tae Hee Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

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

According to the CMS Revalidation Reassignment List (October 2026 release), Tae Hee Kim reassigns Medicare benefits to Southern California Permanente Medical Group (Lancaster, CA). 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 Hee Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tae Hee Kim was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.