DAE WOONG KIM
NPI 1386132652
Physician Assistant in Queen Creek, AZ

Active since April 23, 2018PECOS EnrolledAccepts Medicare Assignment
21321 E OCOTILLO RD STE 133, QUEEN CREEK, AZ 85142(480) 987-5525(480) 987-5115 Get Directions Write a Review

NPPES record last updated: January 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 6, 2023, Aug 18, 2022, Apr 23, 2018 (3 updates tracked since 2018).

About Dae Woong Kim NPPES

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

DAE WOONG KIM (NPI 1386132652) is an individual physician assistant in Queen Creek, Arizona, licensed in Arizona (7074) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1386132652
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDAE WOONG KIM
Location Address21321 E OCOTILLO RD STE 133Queen Creek, AZ 85142-5995
Mailing Address21321 E Ocotillo Rd Ste 133Queen Creek, AZ 85142-5995 · (480) 987-5525 · Fax (480) 987-5115
Fax(480) 987-5115
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateApril 23, 2018
Last NPPES UpdateJanuary 6, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2023
NPI 1386132652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in AZ · 7074
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
21321 E OCOTILLO RD STE 133, Queen Creek, AZ 85142

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dae Woong Kim 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 ID8820352289
PECOS Enrollment IDI20180510002170
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.

Areas of Expertise CMS Part B claims 28

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
509 services102 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
421 services176 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
368 services35 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
231 services41 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
226 services37 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
201 services32 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85142 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

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.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
62%58 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers14 claims14 services$27.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

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

Nurse Practitioner
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Nurse Practitioner (Family)
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Nurse Practitioner (Family)
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Nurse Practitioner (Primary Care)
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Internal Medicine
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Dentist (General Practice)
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Nurse Practitioner (Family)
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142
Nurse Practitioner (Family)
21321 E OCOTILLO RD STE 133
QUEEN CREEK, AZ 85142

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 Dae Woong Kim's NPI number?

The NPI number for Dae Woong Kim is 1386132652. It was assigned to this individual provider in the NPPES registry on April 23, 2018.

Where is Dae Woong Kim located?

Dae Woong Kim practices at 21321 E Ocotillo Rd Ste 133, Queen Creek, AZ 85142. The listed phone number is (480) 987-5525.

What is Dae Woong Kim's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Dae Woong Kim enrolled in Medicare?

Yes. Dae Woong 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.

What insurance does Dae Woong Kim accept?

Health plans from Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. and UnitedHealthcare list Dae Woong 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 Dae Woong Kim was last updated on January 6, 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.