KI WAN KIM MD
NPI 1356490734
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Marietta, GA
About Ki Wan Kim Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KI WAN KIM MD (NPI 1356490734) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Marietta, Georgia, licensed in Georgia (82757) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Accepted Insurance
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
Ki Wan 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.
Medicare Billing Reassignments
2Medicare enrollment records show Ki Wan Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Marietta, GA 30060
- Reassigned Medicare billing, Georgia enrollment
- 3,885 clinicians in this Medicare group
Evanston, IL 60201
- Reassigned Medicare billing, Illinois enrollment
- 4,841 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.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Wellstar Kennestone Regional Medical Center
Acute Care Hospitals · Marietta, GAWellstar Paulding Medical Center
Acute Care Hospitals · Hiram, GAWellstar Cobb Medical Center
Acute Care Hospitals · Austell, GAWellstar Douglas Medical Center
Acute Care Hospitals · Douglasville, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MARIETTA, GA 30060
MARIETTA, GA 30060
MARIETTA, GA 30060
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 Ki Wan Kim's NPI number?
The NPI number for Ki Wan Kim is 1356490734. It was assigned to this individual provider in the NPPES registry on January 9, 2007.
Where is Ki Wan Kim located?
Ki Wan Kim practices at 61 Whitcher St NE Ste 4120, Marietta, GA 30060. The listed phone number is (770) 424-9732.
What is Ki Wan Kim's specialty?
The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.
Is Ki Wan Kim enrolled in Medicare?
Yes. Ki Wan 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 organizations bill Medicare for Ki Wan Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ki Wan Kim reassigns Medicare benefits to 2 organizations: Wellstar Medical Group, LLC (Marietta, GA) and Endeavor Health Medical Group (Evanston, IL). Each 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 Ki Wan Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ki Wan Kim accept?
Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Ki Wan 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.
Is Ki Wan Kim affiliated with any hospitals?
According to CMS data, Ki Wan Kim is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Paulding Medical Center, Wellstar Cobb Medical Center and Wellstar Douglas Medical Center.
When was this NPI record last updated?
The NPPES record for Ki Wan Kim was last updated on October 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Ki Wan Kim, MD · NPI 1356490734
Thoracic Surgery (Cardiothoracic Vascular Surgery) physician in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since January 9, 2007.
## Identity
- **NPI:** 1356490734 (Entity type: Individual)
- **Enumerated:** January 9, 2007
- **Primary specialty:** Thoracic Surgery (Cardiothoracic Vascular Surgery) · taxonomy 208G00000X
- **State license:** 82757 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 61 WHITCHER ST NE STE 4120, Marietta, GA 30060
- **Phone:** (770) 424-9732
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Wellstar Medical Group, LLC (NPI 1760775738, Marietta, GA); Endeavor Health Medical Group (NPI 1497701882, Evanston, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** October 16, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1356490734) · Data from the CMS NPPES public registry.