Charles Kim, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

A142099 Issued in CA

Practice address

1899 W March LN
Stockton, CA 95207-6402

Phone

(209) 623-4700

Fax

(209) 623-4710

NPI assigned

Mar 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Ophthalmology

Education

University of California, Davis School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Sight of Stockton a Medical CorporationGroup PAC ID 2264499037, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.32 of 100Reported as group

Quality

86.51

Improvement activities

40

Cost

79.05

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ckim355861@hisp.ehr.sutterhealth.org
• Direct secure messaging: ckim16093@hpmg.direct-ci.net

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.

• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Modesto, CA
  • NPI 1962426643
  Medicare reassignment Care Compare group NPD
• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Manteca, CA
  • NPI 1013931781

  Ophthalmology

  NPD
• Center for Sight of Stockton a Medical Corporation

  • Specialist
  • Stockton, CA
  • NPI 1326062084

  Ophthalmology

  NPD
• Doctors Medical Center of Modesto, Inc.

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  NPD (past)
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  NPD (past)
• Valley Surgery Center at Modesto, LLC

  • Ambulatory Surgical Clinic/Center
  • Modesto, CA
  • NPI 1235106782
  NPD (past)

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1104242924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1899 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076402",
            "telephone_number": "209-623-4700",
            "fax_number": "209-623-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076402",
            "telephone_number": "209-623-4700",
            "fax_number": "209-623-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-18",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A142099",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A142099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael L. Kiekhaefer, MD
• Autumn Kihlthau
• Christine Kilian
• Kiah Killens
• Caitlin Mary Kilpatrick, FNP
• Cianna Paige Kim
• David Sungtae Kim
• Elizabeth Jungyoon Kim
• Han Kim, M.D.
• Hyung Guen Kim, DDS MSD

• Ophthalmic Plastic and Reconstructive Surgery Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.