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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JAEWAN KIM
NPI 1467276329
Physician Assistant in Goodyear, AZ

Active since November 07, 2024
14455 W VAN BUREN ST # 100, GOODYEAR, AZ 85338(623) 518-2386 Get Directions Write a Review

NPPES record last updated: September 10, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 10, 2026, Nov 7, 2024 (2 updates tracked since 2024).

About Jaewan Kim NPPES

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

JAEWAN KIM (NPI 1467276329) is an individual physician assistant in Goodyear, Arizona, licensed in Texas (PA19903) and active in the NPI registry since November 2024.

NPPES Registry Identity

NPI1467276329
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJAEWAN KIM
Location Address14455 W VAN BUREN ST # 100Goodyear, AZ 85338-9209
Mailing Address14455 W Van Buren St # 100Goodyear, AZ 85338-9209
Phone(623) 518-2386
Sole ProprietorNo
Enumeration DateNovember 7, 2024
Last NPPES UpdateSeptember 10, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2026
✔ NPI 1467276329 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 TX · PA19903
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.
14455 W VAN BUREN ST # 100, Goodyear, AZ 85338
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Other Providers at the Same Location NPPES 10

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

KAFILAT SUMON
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (713) 825-8551
MS. TATIANA ELLEN JAACKS PA
Physician Assistant
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (248) 410-4704
JOYCE AIYED BOTROS
Physician Assistant
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (949) 463-6909
HANA ALSADI
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (623) 518-2386
HEATHER TAMERA DIAMOND
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (623) 518-2386
ELMIRA ALITABAR
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (406) 671-7970
ELISE WEIR
Student in an Organized Health Care Education/Training Program
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (952) 454-8721
ASHLEY ONG
Physician Assistant
14455 W VAN BUREN ST # 100
GOODYEAR, AZ 85338
Maricopa County (480) 630-2276

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 Jaewan Kim's NPI number?

The NPI number for Jaewan Kim is 1467276329. It was assigned to this individual provider in the NPPES registry on November 7, 2024.

Where is Jaewan Kim located?

Jaewan Kim practices at 14455 W Van Buren St # 100, Goodyear, AZ 85338. The listed phone number is (623) 518-2386.

What is Jaewan Kim's specialty?

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

When was this NPI record last updated?

The NPPES record for Jaewan Kim was last updated on September 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.