Individual provider Active NPI

Michelle M. Kim, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1124219456
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A103033 Issued in CA
Practice address
757 Westwood PLZ
Suite 3304
Los Angeles, CA 90095-7403
Phone
(310) 267-8655
Fax
(310) 267-3766
NPI assigned
Aug 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A103033 CA Primary

Addresses

Primary practice location

757 Westwood PLZ
Suite 3304
Los Angeles, CA 90095-7403

Mailing address

757 Westwood PLZ
Suite 3304
Los Angeles, CA 90095-7403
Phone (310) 267-8655

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101122000590 CA Practitioner - Anesthesiology 1850587437 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport Harbor Anesthesia Consultants Medical Group IncGroup PAC ID 1759284771, 86 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 645-8600

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103033CAMDDentist
A103033CAMDAnesthesiology Physician

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1124219456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "SUITE 3304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957403",
            "telephone_number": "310-267-8655",
            "fax_number": "310-267-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "SUITE 3304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957403",
            "telephone_number": "310-267-8655",
            "fax_number": "310-267-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHELLE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A103033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.