Phillip J Kim, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A105129 Issued in CA

Practice address

4770 W Herndon Ave Ste 105
Fresno, CA 93722-8401

Phone

(559) 450-0463

Fax

(559) 450-0464

NPI assigned

Aug 18, 2008

Sex

Male

Sole proprietor

Yes

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

Family Practice

Education

University of California, Geffen School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
• Saint Agnes Home Health and Hospice Home health agency, Fresno, CA, CCN 057135
• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
• San Joaquin Valley Rehabilitation Hosp Inpatient rehabilitation facility, Fresno, CA, CCN 053032

Merit-based Incentive Payment System (MIPS)

Final score

94.52 of 100Reported as individual

Quality

95.59

Promoting interoperability

72

Improvement activities

40

Cost

92.82

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkim2714481@direct.trinity-health.org

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.

• Saint Agnes Medical Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1558819482

  Family Medicine

  Medicare reassignment Care Compare group NPD
• LQMG Medical Group Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1437166360
  NPD
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)

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

• 7173 North Sharon Avenue Operating Company, LLC

  • Rehabilitation Hospital
  • Fresno, CA
  • NPI 1831144716

  Inpatient rehabilitation facility

  Care Compare affiliation
• Compassionate Care Home Health

  • Home Health Agency
  • Fresno, CA
  • NPI 1609826387
  Care Compare affiliation
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation
• Trinity Home Health Services

  • Home Health Agency
  • Fresno, CA
  • NPI 1790873149
  Care Compare affiliation

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1033365341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S ZEDIKER AVE BLDG 1",
            "city": "PARLIER",
            "state": "CA",
            "postal_code": "936482667",
            "telephone_number": "559-646-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 W HERNDON AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228401",
            "telephone_number": "559-450-0463",
            "fax_number": "559-450-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PHILLIP",
        "middle_name": "J",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-18",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70046F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Kim
• Mijeong Kim
• Mimi Kim
• Mina Kim
• Nicole M Kim, PHARM. D.
• Samantha Kim, PHARMD
• Sean Kim, DO
• Shirley Kim, DO
• Soo Y. Kim, M.D.
• Soonmi Kim

• Family Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.