Individual provider Active NPI

Paul Kim, M.D.

  • Interventional Pain Medicine Physician
  • Aliso Viejo, CA
National Provider Identifier
1144541665
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A135423 Issued in CA
Practice address
5 Journey
Suite 220
Aliso Viejo, CA 92656-5336
Phone
(949) 644-5800
NPI assigned
Jun 18, 2010
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X A135423 CA Primary

Addresses

Primary practice location

5 Journey
Suite 220
Aliso Viejo, CA 92656-5336

Mailing address

2415 Campus Dr
Suite 110
Irvine, CA 92612-1527
Phone (949) 644-5800

Other identifiers 1

IdentifierTypeStateIssuer
A135423OtherCACA STATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20150914001075 CA Practitioner - Pain Management 2860709581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
State University of New York at Buffalo School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone (951) 243-0811

27350 Iris Ave
Moreno Valley, CA 92555-4802
Phone (866) 984-7483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A135423CAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 26, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 26, 2018 Accepting new patients
Southern California Spine and Sport Medical Associates, Inc CurrentSince Aug 1, 2015 Accepting new patients

Locations

5 Journey
Ste 220
Aliso Viejo, CA 92656
Phone (714) 861-4630

2415 Campus Dr
Ste 110
Irvine, CA 92612
Phone (949) 999-3600

1401 Avocado Ave
Ste 709
Newport Beach, CA 92660
Phone (949) 644-5800

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

1401 N Tustin Ave
Ste 360
Santa Ana, CA 92705
Phone (949) 644-5800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17238/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1144541665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 CAMPUS DR",
            "address_2": "SUITE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121527",
            "telephone_number": "949-644-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOURNEY",
            "address_2": "SUITE 220",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565336",
            "telephone_number": "949-644-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A135423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "A135423",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.