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JOON TAE KIM
NPI 1477313302
Student in an Organized Health Care Education/Training Program in Stanford, CA

Active since March 19, 2024PECOS Enrolled
291 CAMPUS DR, STANFORD, CA 94305(650) 723-4000 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Joon Tae Kim NPPES

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

JOON TAE KIM (NPI 1477313302) is an individual student in an organized health care education/training program in Stanford, California and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477313302
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJOON TAE KIM
Location Address291 CAMPUS DRStanford, CA 94305-5101
Mailing Address291 Campus DrStanford, CA 94305-5101 · (650) 723-4000
Phone(650) 723-4000
Sole ProprietorNo
Enumeration DateMarch 19, 2024
Last NPPES UpdateJune 17, 2025
NPPES CertifiedJune 17, 2025
✔ NPI 1477313302 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.
291 CAMPUS DR, Stanford, CA 94305
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joon Tae Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

ALEXANDER ISAAC SALTER MD, PHD
Internal Medicine (Hematology & Oncology)
291 CAMPUS DR
PALO ALTO, CA 94305
Santa Clara County (650) 497-8000
KIERA HOOPER
Physician Assistant
291 CAMPUS DR
PALO ALTO, CA 94305
Santa Clara County (925) 302-9283
JACQUELINE PHYLLIS BARNES
Physician Assistant
291 CAMPUS DR
STANFORD, CA 94305
Santa Clara County (508) 686-6865
TENI ANBARCHIAN
Student in an Organized Health Care Education/Training Program
291 CAMPUS DR
STANFORD, CA 94305
Santa Clara County (650) 723-2300
KARYNA BRAVO PA
Physician Assistant
291 CAMPUS DR
STANFORD, CA 94305
Santa Clara County (858) 695-4003
YU JIN LEE
Otolaryngology
291 CAMPUS DR
STANFORD, CA 94305
Santa Clara County (404) 933-8297
MS. KATHERINE KOHLSAAT
Physician Assistant
291 CAMPUS DR
STANFORD, CA 94305
Santa Clara County (781) 786-1481
CAROLINE LIU
Student in an Organized Health Care Education/Training Program
291 CAMPUS DR
STANFORD, CA 94305
Santa Clara County (650) 690-0450

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 Joon Tae Kim's NPI number?

The NPI number for Joon Tae Kim is 1477313302. It was assigned to this individual provider in the NPPES registry on March 19, 2024.

Where is Joon Tae Kim located?

Joon Tae Kim practices at 291 Campus Dr, Stanford, CA 94305. The listed phone number is (650) 723-4000.

What is Joon Tae 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 Joon Tae Kim enrolled in Medicare?

Yes. Joon Tae Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Joon Tae Kim was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.