Individual provider Active NPI

Edward J Kim, M.D., PHD

  • Hematology & Oncology Physician
  • Sacramento, CA
National Provider Identifier
1033237987
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A122547 Issued in CA
Practice address
2279 45TH Street
Sacramento, CA 95817-2229
Phone
(916) 734-5959
Fax
(916) 703-5265
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A122547 CA Primary

Addresses

Primary practice location

2279 45TH Street
Sacramento, CA 95817-2229

Mailing address

4501 X St
Suite 3016
Sacramento, CA 95817-2229
Phone (916) 734-3771

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121228000123 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3476721341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

4501 X St
Sacramento, CA 95817-2229
Phone (916) 734-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Nov 19, 2012 Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 19, 2012 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

3850 G St
Merced, CA 95340
Phone (209) 384-6528

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4501 X St
Ste 3016
Sacramento, CA 95817
Phone (916) 734-3771

2279 45th St
Sacramento, CA 95817
Phone (916) 734-5959

4501 X St
Fl 2
Sacramento, CA 95817
Phone (916) 734-5959

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

Organizations & group practices 5

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1033237987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 X ST",
            "address_2": "SUITE 3016",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172229",
            "telephone_number": "916-734-3771",
            "fax_number": "916-734-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 45TH STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172229",
            "telephone_number": "916-734-5959",
            "fax_number": "916-703-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A122547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.