Haley Kim, OD in Portland, OR - Medicare Optometrist Provider

Haley Kim, OD is a medicare enrolled "Optometrist" provider in Portland, Oregon. Her current practice location is 4880 Ne 104th Ave, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 432-8452.

Haley Kim is licensed to practice in Oregon (license number ATI4521) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104483833.

Contact Information

	Haley Kim, OD
	4880 Ne 104th Ave, Portland, OR 97220-3348
	(503) 432-8452
	(503) 432-8402

Map and Direction

Healthcare Provider's Profile

Full Name	Haley Kim
Gender	Female
Speciality	Optometrist
Location	4880 Ne 104th Ave, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104483833
Provider Enumeration Date: 05/29/2019
Last Update Date: 05/22/2024

Medicare PECOS Information:

PECOS PAC ID: 2769805688
Enrollment ID: I20200710002722

Medical Identifiers

Medical identifiers for Haley Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104483833	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	ATI4521 (Oregon)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Haley Kim allows following entities to bill medicare on her behalf.

Provider Name	M Kwon Pc Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1770727059 PECOS PAC ID: 4981745080 Enrollment ID: O20100112000443

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Haley Kim is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Haley Kim, OD 4880 Ne 104th Ave, Portland, OR 97220-3348 Ph: (503) 432-8452	Haley Kim, OD 4880 Ne 104th Ave, Portland, OR 97220-3348 Ph: (503) 432-8452

Reviews and Comments

Optometrist in Portland, OR

Mrs. Ayla Jade Himmelsbach, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 7826 Sw Capitol Hwy, Portland, OR 97219 Phone: 503-224-7788
Steven J. Clouse, Od Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2609 Se Clinton St, Portland, OR 97202 Phone: 503-238-1139 Fax: 503-235-6574
Hendrix & Mcguire Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4542 Ne Martin Luther King Jr Blvd, Portland, OR 97211 Phone: 503-228-2154 Fax: 503-228-4694
Dr. Larry E Robertson, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 12100 Se Stevens Ct Ste 106, Portland, OR 97266 Phone: 503-653-1442
Dr. Kim M Clark & Associates Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 12000 Se 82nd Avenue, #2012, Portland, OR 97266 Phone: 503-652-6001 Fax: 503-652-6012
Dr. Laura Mae Armstrong, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2021 Ne Alberta St, Portland, OR 97211 Phone: 503-384-2489 Fax: 503-379-9488
Dr. Hayden Minh Nguyen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 8315 Se Stark St, Portland, OR 97216 Phone: 503-282-3070 Fax: 503-287-3482

Haley Kim, OD - Medicare Optometrist in Portland, OR