NPIMap

Individual provider Active NPI

Grace S Kim, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • San Carlos, CA
National Provider Identifier
1083634323
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A76484 Issued in CA
Practice address
1660 San Carlos Ave
San Carlos, CA 94070-2022
Phone
(650) 759-9122
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A76484 CA Primary

Addresses

Primary practice location

1660 San Carlos Ave
San Carlos, CA 94070-2022

Mailing address

220 Standiford Ave Ste F
Modesto, CA 95350-1159
Phone (209) 579-5628

Other identifiers 1

IdentifierTypeStateIssuer
A76484OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000215 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 3779644109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of California, Geffen School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1660 San Carlos Ave
San Carlos, CA 94070-2022
Phone (650) 591-9933

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.95 of 100Reported as individual
Quality
63.31
Improvement activities
40
Cost
72.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A76484CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Kim MD Endocrine Inc Endocrinology, Diabetes & Metabolism CurrentSince May 1, 2023 Accepting new patients
Telehealth Specialty Medical Group CurrentSince Sep 5, 2016 Accepting new patients
Spectrum Orthopedic Sport Therapy CurrentSince Jul 31, 2022 Accepting new patients
Seton Medical Center Past Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients
Sequoia Health Services Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

220 Standiford Ave
Ste F
Modesto, CA 95350
Phone (209) 589-1500

3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628

3400 Douglas Blvd
Ste 225
Roseville, CA 95661
Phone (916) 740-3721

1140 Laurel St
Ste D
San Carlos, CA 94070
Phone (650) 591-9933

1660 San Carlos Ave
San Carlos, CA 94070
Phone (650) 591-9933

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1083634323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STANDIFORD AVE STE F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501159",
            "telephone_number": "209-579-5628",
            "fax_number": "209-579-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 SAN CARLOS AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702022",
            "telephone_number": "650-759-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GRACE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A76484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A76484",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

Verify at the official NPI Registry.