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MR. BONG JIK KIM M.D.
NPI 1891179024
Family Medicine in Waianae, HI

Active since July 17, 2015PECOS Enrolled
89-102 FARRINGTON HWY UNIT 3000, WAIANAE, HI 96792(808) 697-3900(808) 697-3930 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mr. Bong Jik Kim M.d. NPPES

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

MR. BONG JIK KIM M.D. (NPI 1891179024) is an individual family medicine provider in Waianae, Hawaii, licensed in Hawaii (MDR-9039) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1891179024
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. BONG JIK KIMCredential: M.D.
Location Address89-102 FARRINGTON HWY UNIT 3000Waianae, HI 96792-4160
Mailing Address89-102 Farrington Hwy Unit 3000Waianae, HI 96792-4160 · (808) 697-3900 · Fax (808) 697-3930
Phone(808) 697-3900
Fax(808) 697-3930
Sole ProprietorNo
Enumeration DateJuly 17, 2015
Last NPPES UpdateJuly 17, 2026
NPPES CertifiedJuly 17, 2026
✔ NPI 1891179024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in HI · MDR-9039
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
89-102 FARRINGTON HWY UNIT 3000, Waianae, HI 96792
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Secondary Practice Location 1

Location 150 North Medical Drive 3C120, Otolaryngology Administration OfficeSalt Lake City, UT 84132 · Phone (801) 581-7514 · Fax (801) 585-5744

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Bong Jik Kim M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Bong Jik Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Waianae District Comprehensive Health And Hospital Board, Incorporated
Same address
Federally Qualified Health Center (FQHC)
89-102 FARRINGTON HWY UNIT 3000
Waianae, HI 96792
  • Reassigned Medicare billing, Hawaii enrollment
  • 240 clinicians in this Medicare group
NPI 1093880627 (808) 697-3900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96792 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
$92.50 typical visit price
range $60.53 – $180.05
Typical copayment $23.12 (range $15.13 – $45.01)
Most-billed visit code 99203
Established Patient
$105.65 typical visit price
range $20.09 – $147.56
Typical copayment $26.41 (range $5.02 – $36.89)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

LAICA MAE BASINGAN ARCIBAL DO
Family Medicine
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3900
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Clinic/Center (Federally Qualified Health Center (FQHC))
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3900
JIN BAE PAK
Pharmacist
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3950
KIMBERLY KANEMITSU MD
Family Medicine
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3900
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Clinic/Center (Federally Qualified Health Center (FQHC))
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 696-3900
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Clinic/Center
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3900
DEVIN I HAZAMA I DO
Family Medicine (Geriatric Medicine)
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3900
CHERISSE LOHELANI SEN KAWAMURA MD
Family Medicine
89-102 FARRINGTON HWY UNIT 3000
WAIANAE, HI 96792
Honolulu County (808) 697-3900

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 Bong Jik Kim's NPI number?

The NPI number for Bong Jik Kim is 1891179024. It was assigned to this individual provider in the NPPES registry on July 17, 2015.

Where is Bong Jik Kim located?

Bong Jik Kim practices at 89-102 Farrington Hwy Unit 3000, Waianae, HI 96792. The listed phone number is (808) 697-3900.

What is Bong Jik Kim's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Bong Jik Kim enrolled in Medicare?

Yes. Bong Jik Kim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bong Jik Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bong Jik Kim reassigns Medicare benefits to Waianae District Comprehensive Health And Hospital Board, Incorporated (Waianae, HI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bong Jik Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Bong Jik Kim was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.