Thomas Jinkyu Kim, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

A75169 Issued in CA

Practice address

1240 S Westlake Blvd
Suite 205
Westlake Village, CA 91361-1929

Phone

(805) 495-0551

Fax

(805) 496-8079

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Dermatology

Education

Chicago College of Medicine and Surgery, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Westlake Village PCGroup PAC ID 7416352539, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Integrated Dermatology of Westlake Village, PC

  • Dermatology Physician
  • Westlake Village, CA
  • NPI 1295302917
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1033179072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 S WESTLAKE BLVD",
            "address_2": "SUITE 205",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611929",
            "telephone_number": "805-495-0551",
            "fax_number": "805-496-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S WESTLAKE BLVD",
            "address_2": "SUITE 205",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611929",
            "telephone_number": "805-495-0551",
            "fax_number": "805-496-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "THOMAS",
        "middle_name": "JINKYU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A75169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033179072",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eleanor Kim, PH.D.
• Eun Sang Sang Kim
• Jiyoung Kim
• Kap Ryong Kim, D.C., LA.C
• Sujin Kim, PA
• Kimberly Yudt, Licensed Clinical Social Worker Corp.
• Debra L King, MA
• Kinney Physical Therapy & Wellness,P.C.
• Daniel Kinney, PT
• Zora Kirby

• Specialist in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.