Active NPI
Thomas C. Kim, M.D.
- Specialist
- Orange, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A79886
- Practice address
- 1140 W la Veta Ave Ste 430
Orange, CA 92868-4226 - Phone
- (714) 543-5555
- Fax
- (714) 973-7731
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A79886 | CA | Primary |
Addresses
Primary practice location
1140 W la Veta Ave Ste 430
Orange, CA 92868-4226
Mailing address
1140 W la Veta Ave Ste 430
Orange, CA 92868-4226
Phone (714) 543-5555
Other practice location 1
700 N Tustin Ave
Santa Ana, CA 92705-3602
Phone (714) 245-1444
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DB3373 | Other | CA | RAILROAD MEDICARE |
| W13988 | Other | CA | MEDICARE PTAN |
| W13988A | Other | CA | MEDICARE PTAN |
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
- Cardiovascular Disease (Cardiology)
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006
1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111
1140 W la Veta Ave
Suite 430
Orange, CA 92868-4226
Phone (714) 543-5555
1140 W la Veta Ave
Suite 770
Orange, CA 92868-4229
Phone (714) 835-8715
1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350
200 W Ctr St Promenade
Anaheim, CA 92805-3960
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A79886 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Hoag Memorial Hospital Presbyterian | Past | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Cardiology Specialists of Orange County | Specialist | Past | Accepting new patients |
| Mayo Clinic Health System-Southwest Minnesota Region | Past | Accepting new patients |
Locations
279 Imperial Hwy
Ste 730
Fullerton, CA 92835
Phone (714) 449-4841
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
1140 W La Veta Ave
Ste 430
Orange, CA 92868
Phone (714) 543-5555
700 N Tustin Ave
Santa Ana, CA 92705
Phone (714) 245-1444
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DCIGAA
- tkim1373193@oc.providencedirect.org
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
- Specialist
- Santa Ana, CA
- NPI 1831137314
-
- General Acute Care Hospital
- Newport Beach, CA
- NPI 1518951300
-
- General Acute Care Hospital
- Eureka, CA
- NPI 1609858950
-
- General Acute Care Hospital
- Mankato, MN
- NPI 1154302487
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orange, CA
- NPI 1912982216
-
- General Acute Care Hospital
- Orange, CA
- NPI 1558575746
-
- General Acute Care Hospital
- Orange, CA
- NPI 1689608150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1144225301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 W LA VETA AVE STE 430",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684226",
"telephone_number": "714-543-5555",
"fax_number": "714-973-7731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 W LA VETA AVE STE 430",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684226",
"telephone_number": "714-543-5555",
"fax_number": "714-973-7731"
}
],
"practiceLocations": [
{
"address_1": "700 N Tustin Ave",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927053602",
"country_code": "US",
"telephone_number": "714-245-1444",
"fax_number": "714-953-6604",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "THOMAS",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A79886",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DB3373",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "W13988",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "W13988A",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.