Peter K. Kim, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A67819 Issued in CA

Practice address

1195 Roadrunner Way
Simi Valley, CA 93065-0000

Phone

(805) 579-8892

Fax

(805) 579-8951

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Neurology

Education

Meharry Medical College School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.28 of 100Reported as individual

Quality

56.39

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Peter Kim MD Inc

  • Neurology Physician
  • Simi Valley, CA
  • NPI 1760411946

  Neuromuscular Medicine

  Medicare reassignment NPD Authorized official
• Los Robles Regional Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1033163019
  NPD (past)
• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1053534610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 ROADRUNNER WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650000",
            "telephone_number": "805-579-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 ROADRUNNER WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650000",
            "telephone_number": "805-579-8892",
            "fax_number": "805-579-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "CA",
            "license": "A67819",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A67819",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A67819",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A678190",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR ID NUM",
            "identifier": "609916600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chuhyun Kim, L.AC
• Daniel Kim, M.D.
• Edward Kim, DDS
• Jun Yung Kim, FNP
• Nam Hui Kim
• Pyo Y Kim, L.AC.
• Jessica King, MPH, RDN
• Kingdrive Logistics LLC
• Yesayi Kirakosyan
• Alexandra Marguerite Kirk

• Neurology Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.