Individual provider Active NPI

James Hyun-Tae Kim, M.D.

  • Anesthesiology Physician
  • Santa Monica, CA
National Provider Identifier
1275977407
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A134852 Issued in CA
Practice address
1328 22ND St
Santa Monica, CA 90404-2032
Phone
(310) 829-5511
NPI assigned
Apr 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A134852 CA Primary

Addresses

Primary practice location

1328 22ND St
Santa Monica, CA 90404-2032

Mailing address

1423 Comstock Ave
Los Angeles, CA 90024-5316
Phone (310) 435-9425

Other practice location 1

5901 E 7th St
Long Beach, CA 90822-5201
Phone (562) 826-8000

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
I20181004002578 CA Practitioner - Anesthesiology 5395054050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayside Anesthesia Medical GroupGroup PAC ID 2466490560, 47 clinicians

Practice addresses (Care Compare)

1328 22ND St
St Johns Hospital
Santa Monica, CA 90404-2091
Phone (310) 477-2465

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134852CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Anesthesia Medical Group CurrentSince Oct 1, 2018 Accepting new patients

Locations

1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511

Organizations & group practices 1

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 1

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": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1275977407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 COMSTOCK AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245316",
            "telephone_number": "310-435-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 22ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042032",
            "telephone_number": "310-829-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908225201",
            "country_code": "US",
            "telephone_number": "562-826-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAMES",
        "middle_name": "HYUN-TAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-18",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A134852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.