Agnes (Yang Eun) Pyong Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12313T Issued in CA

Practice address

1021 Arnold Dr
Located Inside Wal-Mart
Martinez, CA 94553-4103

Phone

(925) 957-9378

Fax

(925) 957-9417

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Yang Eun Pyong Kim Other name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Krok and Shen Optometrists IncGroup PAC ID 5496030686, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Krok and Shen Optometrists Inc

  • Optometrist
  • Santa Cruz, CA
  • NPI 1891999660
  Medicare reassignment Care Compare group NPD
• North Coast Vision

  • Optometrist
  • Santa Cruz, CA
  • NPI 1619158755
  Medicare reassignment NPD Authorized official
• Luxottica of America Inc.

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063537397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6084 RALSTON AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948051202",
            "telephone_number": "510-215-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 ARNOLD DR",
            "address_2": "LOCATED INSIDE WAL-MART",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534103",
            "telephone_number": "925-957-9378",
            "fax_number": "925-957-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "AGNES (YANG EUN)",
        "middle_name": "PYONG",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12313T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YANG EUN",
            "last_name": "KIM",
            "middle_name": "PYONG",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Asiya Khan, M.D.
• Tamseel Khan, LVN
• Monika Khurana
• Emily Louise Kich, OTR/L
• Joy Kick
• Ben Yong-Il Kim, DDS
• Brittany Hope Kim, MD
• Hye Kyung Kim, MD
• Mi-Jin Kim, D.D.S.
• Yoen Kim

• Optometrist in Martinez, CA
• Providers in Martinez, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.