Peter K. Kim, M.D.
NPI 1205943511ActiveIndividual· Surgery· Warwick, RI
Surgery (M.D.) with Tanana Valley Clinic LLC and 2 other groups, practicing in Warwick, Rhode Island. Mostly services rather than prescriptions: Medicare paid $11,737 for 41 patients in 2024, with only 13 Part D claims. Lists Fairbanks Memorial Hospital and 1 other hospital as hospital affiliations.
Overview
| NPI | 1205943511 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | Yes |
| NPI issued | Aug 23, 2006 |
| Last updated in NPPES | Jan 9, 2023 |
| Certified by provider | Jan 9, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | MD18930 | RI |
| Surgery | 208600000X | 235272 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - General Surgery (AK); Practitioner - General Surgery (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 41 |
|---|---|
| Services billed | 96 across 27 procedure codes |
| Paid by Medicare | $11,737 |
Part D prescriptions in 2024
| Prescriptions (claims) | 13 · 13 30-day fills |
|---|---|
| Total drug cost | $84.58 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 1997 |
|---|---|
| Medicare specialty | General Surgery |
Medical groups
- Tanana Valley Clinic LLCFairbanks, AK · 146 clinicians
- Bay Area Hospital DistrictCoos Bay, OR · 122 clinicians
- Grande Ronde Hospital IncLa Grande, OR · 97 clinicians
Hospital affiliations
- Fairbanks Memorial HospitalFairbanks, AK
- Grande Ronde HospitalLa Grande, OR
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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