Jonathan Kim, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E5392 Issued in CA

Practice address

81709 Dr Carreon Blvd Ste D3
Indio, CA 92201-5578

Phone

(760) 863-0070

NPI assigned

Oct 20, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Home Foot Care IncGroup PAC ID 4981744257, 25 clinicians

C P GGroup PAC ID 3072866300, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (10 of 11)

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.

• Home Foot Care, Inc.

  • Podiatrist
  • Van Nuys, CA
  • NPI 1447480785
  Medicare reassignment Care Compare group NPD
• Jonathan D Kim DPM PC

  • Foot & Ankle Surgery Podiatrist
  • San Gabriel, CA
  • NPI 1376384727
  Medicare reassignment NPD Authorized official
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• C P G

  • Foot & Ankle Surgery Podiatrist
  • Huntington Park, CA
  • NPI 1083196562
  Medicare reassignment Care Compare group
• Convalescent Podiatry Care a Professional Corporation

  • Podiatrist
  • Lakewood, CA
  • NPI 1306606579
  Medicare reassignment NPD
• Michael D. Kotzen, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Valley Village, CA
  • NPI 1013105972
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Rosemead, CA
  • NPI 1942787114
  NPD
• Foot and Ankle Associates of the Desert

  • Foot & Ankle Surgery Podiatrist
  • Indio, CA
  • NPI 1649487992
  NPD (past)
• San Bernardino Medical Group Inc

  • Clinic/Center
  • San Bernardino, CA
  • NPI 1558331231
  NPD (past)
• Primecare Medical Group

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1093720427
  NPD (past)

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1104220102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74000 COUNTRY CLUB DR STE E4",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922601678",
            "telephone_number": "760-848-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81709 DR CARREON BLVD STE D3",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015578",
            "telephone_number": "760-863-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16465 Sierra Lakes Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923361242",
            "country_code": "US",
            "telephone_number": "909-427-9522",
            "fax_number": "909-697-2180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "728 N Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917622712",
            "country_code": "US",
            "telephone_number": "909-984-5614",
            "fax_number": "909-984-4759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15944 Los Serranos Country Club Dr",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917093993",
            "country_code": "US",
            "telephone_number": "909-287-0677",
            "fax_number": "909-631-2919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONATHAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2023-10-27",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Killian, LVN
• Esther Kim
• Evelyn Sungmin Kim, PHARMD
• Hyun Il Kim
• Jessica Jeehyun Kim
• William Woo Kyeom Kim, DDS
• Leo J King, PT
• Theodora King, MFT INTERN
• Nicole Kippel, ACSW
• Amber Kirby

• Podiatrist in Indio, CA
• Providers in Indio, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.