Individual provider Active NPI

Esther Hyeun Kim, PA-C

  • Physician Assistant
  • Roseville, CA
National Provider Identifier
1336622695
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56969 Issued in CA
Practice address
3400 Douglas Blvd Ste 170
Roseville, CA 95661-4281
Phone
(562) 268-0955
Fax
(916) 783-0513
NPI assigned
Sep 12, 2018
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56969 CA Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

3400 Douglas Blvd Ste 170
Roseville, CA 95661-4281

Mailing address

3400 Douglas Blvd Ste 170
Roseville, CA 95661-4281
Phone (562) 268-0955

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829000118 CA Practitioner - Physician Assistant 4688902646 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Telemedicine Group PCGroup PAC ID 9830351824, 94 clinicians

Practice addresses (Care Compare)

3400 Douglas Blvd
Suite 170
Roseville, CA 95661-4281
Phone (916) 740-3721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56969CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Felton Institute CurrentSince Sep 14, 2022 Accepting new patients
Felton Institute CurrentSince Sep 14, 2022 Accepting new patients
County of Solano CurrentSince May 17, 2021 Accepting new patients
County of Solano CurrentSince May 17, 2021 Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients
Felton Institute Past Accepting new patients

Locations

1005 Atlantic Ave
Alameda, CA 94501
Phone (510) 318-6100

275 Beck Ave
#5210
Fairfield, CA 94533
Phone (707) 784-8315

2101 Courage Dr
Fairfield, CA 94533
Phone (707) 428-1131

1814 Franklin St
Oakland, CA 94612
Phone (510) 318-6100

30 E San Joaquin St
Ste 102
Salinas, CA 93901
Phone (831) 393-5994

1500 Franklin St
San Francisco, CA 94109

6221 Geary Blvd
San Francisco, CA 94121
Phone (415) 251-5770

1108 S El Camino Real
San Mateo, CA 94402
Phone (650) 458-0026

361 3rd St
Ste B
San Rafael, CA 94901
Phone (415) 747-8178

Interoperability endpoints

  • Direct secure messaging: telemed2u.estherkim@160918.advancedmd-direct.com

Organizations & group practices 8

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": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1336622695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 170",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614281",
            "telephone_number": "562-268-0955",
            "fax_number": "916-783-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 170",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614281",
            "telephone_number": "562-268-0955",
            "fax_number": "916-783-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ESTHER",
        "middle_name": "HYEUN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56969",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.