Active NPI
Stacey Kim, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 115491
- Practice address
- 8700 Beverly Blvd
South Tower, Room 8709
Los Angeles, CA 90048 - Phone
- (310) 423-6941
- NPI assigned
- Jun 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | LP01253 | RI | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 115491 | CA | Primary |
Addresses
Primary practice location
8700 Beverly Blvd
South Tower, Room 8709
Los Angeles, CA 90048
Mailing address
8700 Beverly Blvd
South Tower, Room 8709
Los Angeles, CA 90048
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- University of Texas Southwestern Medical School at Dallas, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6955 Foothill Blvd
Suite 200
Oakland, CA 94605-2426
Phone (510) 567-5704
Hospital & facility affiliations
- Highland Hospital
- Alameda Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.17 of 100
- Quality
- 86.93
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP01253 | RI | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alameda Health System | Current | Accepting new patients | |
| Alameda Health System | Current | Accepting new patients | |
| Alameda Health System | Current | Accepting new patients | |
| Cedars-Sinai Medical Center | Past | Accepting new patients | |
| New York Westchester SQ Med Ctr | Past | Accepting new patients | |
| Alameda Health System | Past | Accepting new patients |
Locations
815 Atlantic Ave
Ste 100
Alameda, CA 94501
Phone (510) 522-6637
15400 Foothill Blvd
Castro Valley, CA 94578
Phone (510) 346-1468
664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700
6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600
1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323
7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768
6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700
13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500
Organizations & group practices 6
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.
-
- Surgery Physician
- Oakland, CA
- NPI 1740332931
-
- Federally Qualified Health Center (FQHC)
- Hayward, CA
- NPI 1023219821
-
- Federally Qualified Health Center (FQHC)
- Newark, CA
- NPI 1497956288
-
- General Acute Care Hospital
- Oakland, CA
- NPI 1083815872
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1639172372
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1851340608
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oakland, CA
- NPI 1083815872
-
- General Acute Care Hospital
- Oakland, CA
- NPI 1396764353
-
- General Acute Care Hospital
- Oakland, CA
- NPI 1700087590
-
- General Acute Care Hospital
- Alameda, CA
- NPI 1831529049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311120000000",
"number": "1114123171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD",
"address_2": "SOUTH TOWER, ROOM 8709",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD",
"address_2": "SOUTH TOWER, ROOM 8709",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90048",
"telephone_number": "310-423-6941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "STACEY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-26",
"last_updated": "2011-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "RI",
"license": "LP01253",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CA",
"license": "115491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.