DR. JAESUNG KIM M.D.
NPI 1962834796
Psychiatry & Neurology - Neurology in Vancouver, WA

Q: What is Jaesung Kim's NPI number?

The NPI number for Jaesung Kim is 1962834796. It was assigned to this individual provider in the NPPES registry on August 2, 2013.

Q: What is Jaesung Kim's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for Jaesung Kim was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 August 02, 2013PECOS EnrolledAccepts Medicare Assignment

2211 NE 139TH ST, VANCOUVER, WA 98686(360) 487-1000 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 29, 2020, Mar 17, 2018, Sep 14, 2017 (3 updates tracked since 2017).

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About Dr. Jaesung Kim M.d. NPPES

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

DR. JAESUNG KIM M.D. (NPI 1962834796) is an individual neurology provider in Vancouver, Washington, licensed in Washington (MD61054444) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS, is affiliated with Legacy Mount Hood Medical Center, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1962834796

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameDR. JAESUNG KIMCredential: M.D.

Location Address2211 NE 139TH STVancouver, WA 98686

Mailing AddressPo Box 2777Portland, OR 97208-2777

Phone(360) 487-1000

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateAugust 2, 2013

Last NPPES UpdateJuly 23, 20253 updates tracked since enumeration

NPPES CertifiedJuly 23, 2025

✔ NPI 1962834796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

Licenses✔ Licensed in WA · MD61054444✔ Licensed in OK · 33238✔ Licensed in OR · MD226000

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

2211 NE 139TH ST, Vancouver, WA 98686

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Secondary Practice Locations 4

Location 1505 NE 87th Ave Ste 460Vancouver, WA 98664-1965 · Phone (360) 514-7771 · Fax (360) 514-7769

Location 21120 S Utica AveTulsa, OK 74104-4012 · Phone (918) 579-1000 · Fax (918) 560-5761

Location 32801 N Gantenbein AvePortland, OR 97227 · Phone (503) 413-2200

Location 42451 Fillingim St, Res Box 7th FloorMobile, AL 36617-2238 · Phone (251) 471-7207

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jaesung Kim M.d. 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 ID4789959404

PECOS Enrollment IDI20201111001271, I20250807002889

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 Reassignments

Medicare enrollment records show Jaesung Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Legacy Salmon Creek Hospital

Same address

Clinic/Center

2211 NE 139TH ST
Vancouver, WA 98686

Reassigned Medicare billing, Washington enrollment
754 clinicians in this Medicare group

NPI 1356357784 (360) 487-2878

Legacy Clinics LLC

13 mi

Clinic/Center

1130 NW 22ND AVE STE 220
Portland, OR 97210

Reassigned Medicare billing, Oregon enrollment
1,248 clinicians in this Medicare group

NPI 1902827272 (503) 413-2901

Silverton Health

40 mi

Clinic/Center

861 W MAIN ST
Molalla, OR 97038

Reassigned Medicare billing, Oregon enrollment
568 clinicians in this Medicare group

NPI 1861116055 (503) 874-5653

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

Areas of Expertise CMS Part B claims 4

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

120 services98 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

106 services83 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

73 services73 patients

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.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Legacy Mount Hood Medical Center

Acute Care Hospitals · Gresham, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380025

Location24800 SE Stark StreetGresham, OR 97030 · Multnomah County

Emergency services Birthing friendly

Peacehealth Southwest Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500050

Location400 NE Mother Joseph PlaceVancouver, WA 98668 · Clark 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 98686 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

$130.99 typical visit price

range $57.27 – $172.80

Typical copayment $32.74 (range $14.31 – $43.20)

Most-billed visit code 99204

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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 20

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

DR. NATALIA SAYURI MUTO MD

Student in an Organized Health Care Education/Training Program