YOUNGWAN KIM MD
NPI 1780435552
Student in an Organized Health Care Education/Training Program in Tampa, FL

Q: What is Youngwan Kim's NPI number?

The NPI number for Youngwan Kim is 1780435552. It was assigned to this individual provider in the NPPES registry on March 29, 2024.

Q: What is Youngwan Kim's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Youngwan Kim was last updated on October 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since March 29, 2024PECOS Enrolled

4620 N 22ND ST, TAMPA, FL 33610(813) 397-5300 Get Directions Write a Review

NPPES record last updated: October 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Youngwan Kim Md NPPES

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

YOUNGWAN KIM MD (NPI 1780435552) is an individual student in an organized health care education/training program in Tampa, Florida and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780435552

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameYOUNGWAN KIMCredential: MD

Location Address4620 N 22ND STTampa, FL 33610-6205

Mailing Address4620 N 22nd StTampa, FL 33610-6205 · (813) 397-5300

Phone(813) 397-5300

Sole ProprietorNo

Enumeration DateMarch 29, 2024

Last NPPES UpdateOctober 21, 2024

NPPES CertifiedOctober 21, 2024

✔ NPI 1780435552 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.

4620 N 22ND ST, Tampa, FL 33610

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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)

Youngwan Kim Md 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.

TAMPA FAMILY HEALTH CENTERS, INC.

Clinic/Center (Federally Qualified Health Center (FQHC))