Individual provider Active NPI

Kim Hoang Bui, M.D.

  • Obstetrics & Gynecology Physician
  • Pasadena, CA
National Provider Identifier
1164871133
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A168848 Issued in CA
Practice address
625 S Fair Oaks Ave
Suite 255
Pasadena, CA 91105-2613
Phone
(626) 304-2626
Fax
(626) 585-0695
NPI assigned
Jun 9, 2016
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A168848 CA
Obstetrics & Gynecology Physician 207V00000X A168848 CA Primary

Addresses

Primary practice location

625 S Fair Oaks Ave
Suite 255
Pasadena, CA 91105-2613

Mailing address

625 S Fair Oaks Ave
Suite 255
Pasadena, CA 91105-2613
Phone (626) 304-2626

Other identifiers 2

IdentifierTypeStateIssuer
A168848OtherCAOBGYN
954302200OtherCATAX ID #

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
I20221117003330 CA Practitioner - Obstetrics/Gynecology 0446530588 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168848CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 27, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 27, 2023 Accepting new patients

Locations

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1164871133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE",
            "address_2": "SUITE 255",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052613",
            "telephone_number": "626-304-2626",
            "fax_number": "626-585-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE",
            "address_2": "SUITE 255",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052613",
            "telephone_number": "626-304-2626",
            "fax_number": "626-585-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "KIM",
        "middle_name": "HOANG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2023-07-07",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A168848",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A168848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBGYN",
            "identifier": "A168848",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "954302200",
            "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": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.