Individual provider Active NPI

Ina Kim, MD

  • Emergency Medicine Physician
  • Yuma, AZ
National Provider Identifier
1003496050
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
71568 Issued in AZ
Practice address
2400 S Avenue a
Yuma, AZ 85364-7127
Phone
(702) 853-3561
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 71568 AZ Primary

Addresses

Primary practice location

2400 S Avenue a
Yuma, AZ 85364-7127

Mailing address

3762 Clairemont Dr
San Diego, CA 92117-5916
Phone (858) 381-2438

Other practice location 1

15615 Pomerado Rd
Poway, CA 92064-2405
Phone (858) 381-2438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250507002364 AZ Practitioner - Emergency Medicine 2062821564 Reassigns benefits to 1 organization
I20250724002018 CA Practitioner - Emergency Medicine 2062821564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Toledo College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palomar Emergency Physicians, IncGroup PAC ID 9830593730, 71 clinicians
Sierra Estrellas Emergency Physicians LLCGroup PAC ID 5193002954, 38 clinicians

Practice addresses (Care Compare)

15615 Pomerado Rd
Poway, CA 92064-2405
Phone (310) 379-2134

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Hospital & facility affiliations

  • Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013
  • Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
71568AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palomar Emergency Physicians, Inc Emergency Medicine CurrentSince Jul 15, 2025 Accepting new patients
Sierra Estrellas Emergency Physicians LLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

1500 S Mill Ave
Tempe, AZ 85281
Phone (480) 784-5500

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1003496050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3762 CLAIREMONT DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175916",
            "telephone_number": "858-381-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "702-853-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15615 Pomerado Rd",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920642405",
            "country_code": "US",
            "telephone_number": "858-381-2438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "INA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "71568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.