DR. SHANE CHRISTOPHER KIM MD
NPI 1871623678
Plastic Surgery in Portland, OR

Q: What is Shane Kim's NPI number?

The NPI number for Shane Kim is 1871623678. It was assigned to this individual provider in the NPPES registry on March 7, 2007.

Q: What is Shane Kim's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Kim was last updated on July 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since March 07, 2007PECOS EnrolledAccepts Medicare Assignment

86.03/100

CMS Quality Rating

1130 NW 22ND AVE STE 420, PORTLAND, OR 97210(503) 413-4992(503) 413-3699 Get Directions Write a Review

NPPES record last updated: July 15, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Shane Christopher Kim Md NPPES

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

DR. SHANE CHRISTOPHER KIM MD (NPI 1871623678) is an individual plastic surgery provider in Portland, Oregon, licensed in Oregon (MD29423) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Legacy Good Samaritan Medical Center, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1871623678

Entity TypeIndividualMale

Primary Taxonomy208200000X

Provider Legal NameDR. SHANE CHRISTOPHER KIMCredential: MD

Location Address1130 NW 22ND AVE STE 420Portland, OR 97210-2995

Mailing Address1130 Nw 22nd Ave Ste 420Portland, OR 97210-2995 · (503) 413-4992 · Fax (503) 413-3699

Phone(503) 413-4992

Fax(503) 413-3699

Sole ProprietorYes

Medical School CMSOtherGraduated 2002

Enumeration DateMarch 7, 2007

Last NPPES UpdateJuly 15, 2013

✔ NPI 1871623678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in OR · MD29423

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

1130 NW 22ND AVE STE 420, Portland, OR 97210

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.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

Dr. Shane Christopher 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.

PECOS PAC ID4789745787

PECOS Enrollment IDI20090803000240, I20231006001994

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 3

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

46 services42 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

20 services20 patients

Release of wrist ligament using an endoscope 29848

This procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.

18 services16 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380017

Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County

Emergency services Birthing friendly

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500150

Location2211 NE 139th StreetVancouver, WA 98686 · Clark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97210 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

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

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.

86.03/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

77.8

Promoting Interoperability

Improvement Activities

Cost

74.15

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 Shane Kim's NPI number?

The NPI number for Shane Kim is 1871623678. It was assigned to this individual provider in the NPPES registry on March 7, 2007.

Where is Shane Kim located?

Shane Kim practices at 1130 NW 22nd Ave Ste 420, Portland, OR 97210. The listed phone number is (503) 413-4992.

What is Shane Kim's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Shane Kim enrolled in Medicare?

Yes. Shane 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 Shane Kim accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Shane 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 Shane Kim affiliated with any hospitals?

According to CMS data, Shane Kim is affiliated with Legacy Good Samaritan Medical Center and Legacy Salmon Creek Medical Center.

When was this NPI record last updated?

The NPPES record for Shane Kim was last updated on July 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.