Dr Shane Christopher Kim, MD - Medicare Plastic And Reconstructive Surgery in Portland, OR

Dr Shane Christopher Kim, MD is a medicare enrolled "Plastic Surgery" physician in Portland, Oregon. He graduated from medical school in 2002 and has 22 years of diverse experience with area of expertise as Plastic And Reconstructive Surgery. He is a member of the group practice Legacy Clinics Llc and his current practice location is 1130 Nw 22nd Ave Ste 420, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 413-4992.

Dr Shane Christopher Kim is licensed to practice in Oregon (license number MD29423) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1871623678.

Contact Information

Dr Shane Christopher Kim, MD
1130 Nw 22nd Ave Ste 420,
Portland, OR 97210-2995
(503) 413-4992
(503) 413-3699



Physician's Profile

Full NameDr Shane Christopher Kim
GenderMale
SpecialityPlastic And Reconstructive Surgery
Experience22 Years
Location1130 Nw 22nd Ave Ste 420, Portland, Oregon
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Shane Christopher Kim graduated from medical school in 2002
  NPI Data:
  • NPI Number: 1871623678
  • Provider Enumeration Date: 03/07/2007
  • Last Update Date: 07/15/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 4789745787
  • Enrollment ID: I20090803000240

Medical Identifiers

Medical identifiers for Dr Shane Christopher Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871623678NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208200000XPlastic Surgery MD29423 (Oregon)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Legacy Good Samaritan Medical CenterPortland, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Legacy Clinics Llc0244144004603

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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. Dr Shane Christopher Kim allows following entities to bill medicare on his behalf.
Entity NameLegacy Clinics Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1902827272
PECOS PAC ID: 0244144004
Enrollment ID: O20031117000089

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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. Dr Shane Christopher 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 AddressPractice Location Address
Dr Shane Christopher Kim, MD
1130 Nw 22nd Ave Ste 420,
Portland, OR 97210-2995

Ph: (503) 413-4992
Dr Shane Christopher Kim, MD
1130 Nw 22nd Ave Ste 420,
Portland, OR 97210-2995

Ph: (503) 413-4992

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Plastic Surgery Doctors in Portland, OR

Dr. Michael F. Bohley, M.D.,P.C.
Plastic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 10201 Se Main St Ste 20, Portland, OR 97216
Phone: 503-253-3458    Fax: 503-253-0856
Erik Matthew Wolfswinkel, M.D.
Plastic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239
Phone: 503-494-6687    Fax: 503-494-1717
Dr. Stiles Turner Jewett Jr., M.D.
Plastic Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 12400 Nw Cornell Rd, Suite 200, Portland, OR 97229
Phone: 503-646-0101    Fax: 503-350-1420
Michelle Bonapace-potvin, MD
Plastic Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 3303 S Bond Ave Bldg 1, Portland, OR 97239
Phone: 150-349-4668    
Dr. Geoffrey Harry Buncke, M.D.
Plastic Surgery
Medicare: Medicare Enrolled
Practice Location: 1040 Nw 22nd Ave, Suite 550, Portland, OR 97209
Phone: 503-973-5000    Fax: 503-274-0188
Dr. Michael John Wheatley, MD
Plastic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 501 N Graham St, Suite 330, Portland, OR 97227
Phone: 503-413-3650    Fax: 503-413-3644
Reid Vance Mueller, MD
Plastic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239
Phone: 503-494-6687    

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