Individual provider Active NPI

Thomas C. Kim, M.D.

  • Specialist
  • Orange, CA
National Provider Identifier
1144225301
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A79886 Issued in CA
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

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
DB3373OtherCARAILROAD MEDICARE
W13988OtherCAMEDICARE PTAN
W13988AOtherCAMEDICARE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080313000179 CA Practitioner - Cardiovascular Disease (Cardiology) 1759466808 Reassigns benefits to 1 organization

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
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

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

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A79886CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 6, 2010 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Sep 6, 2010 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

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCIGAA
  • Direct secure messaging: 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.

Hospital & facility affiliations 4

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": "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

Verify at the official NPI Registry.