Kenneth W Kim, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

A81692 Issued in CA

Practice address

450 N Wiget LN
Walnut Creek, CA 94598-2408

Phone

(925) 691-9806

Fax

(925) 691-9807

NPI assigned

Jun 10, 2005

Last updated

Oct 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Pain Management

Education

Hahnemann University College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrated Pain Management Medical Group IncGroup PAC ID 0547252918, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
• John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Integrated Pain Management Medical Group, Inc.

  dba Boomerang Healthcare

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1922198779
  Medicare reassignment Care Compare group NPD
• Alameda Health System

  dba Highland General Hospital

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1396764353
  NPD (past)
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• John Muir Health

  dba John Muir Health Medical Center, Concord Campus

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  NPD (past)
• Sutter Delta Medical Center

  • General Acute Care Hospital
  • Antioch, CA
  • NPI 1124135132
  NPD (past)

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

• John Muir Health

  dba John Muir Health, Walnut Creek Medical Center

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation
• John Muir Health

  dba John Muir Health Medical Center, Concord Campus

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  Care Compare affiliation

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1154325777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N WIGET LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982408",
            "telephone_number": "925-691-9806",
            "fax_number": "925-691-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N WIGET LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982408",
            "telephone_number": "925-691-9806",
            "fax_number": "925-691-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KENNETH",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A81692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeehong Kim, M.D
• Jennifer Kim, DPM
• Joanne Y. Kim, MD
• John Y. Kim, MD
• Jooyeon Kim
• Lauren Kim
• Lisa Taehyung Kim, DO
• Lucia C Kim, MD, MPH
• Michelle Kim
• Paul Kim

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.

Verify at the official NPI Registry.