Individual provider Active NPI

Edward H. Kim, D.P.M.

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1346264595
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
BK5973842 Issued in CA
Practice address
1245 Wilshire Blvd Ste 202
Los Angeles, CA 90017-4810
Phone
(213) 365-1000
Fax
(213) 365-2177
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4062 CA
Podiatrist 213E00000X BK5973842 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd Ste 202
Los Angeles, CA 90017-4810

Mailing address

1245 Wilshire Blvd Ste 810
Los Angeles, CA 90017-4808
Phone (213) 365-1000

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220001037 CA Practitioner - Podiatry 5193610749 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 810
Los Angeles, CA 90017-4808
Phone (213) 365-1000

434 San Vicente Blvd
2ND FL
Los Angeles, CA 90048-4108

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue14
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4062CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Interventional Partners Inc Podiatrist CurrentSince Feb 3, 2018 Accepting new patients
Ehk Medical Corp Foot & Ankle Surgery CurrentSince Feb 7, 2002 Accepting new patients
Arthur Kreitenberg, M.D., PC Past Accepting new patients
Footfix Apc Foot & Ankle Surgery PastSince Jun 9, 2018 Accepting new patients
Roohbakhsh Maher DPM. Inc Podiatrist PastSince Feb 1, 2004 Accepting new patients
Foot & Ankle Champions Incd Foot & Ankle Surgery Past Accepting new patients

Locations

8420 Wilshire Blvd
Beverly Hills, CA 90211
Phone (310) 903-1043

1245 Wilshire Blvd
Ste 810
Los Angeles, CA 90017
Phone (213) 365-1000

3663 W 6th St
Ste 202
Los Angeles, CA 90020
Phone (213) 365-1000

434 S San Vicente Blvd
#2
Los Angeles, CA 90048
Phone (310) 659-3400

434 S San Vicente Blvd
Fl 2
Los Angeles, CA 90048
Phone (213) 365-1000

18375 Ventura Blvd
Tarzana, CA 91356
Phone (818) 422-5322

935 S Sunset Ave
West Covina, CA 91790
Phone (626) 888-7414

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1346264595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 810",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174808",
            "telephone_number": "213-365-1000",
            "fax_number": "213-365-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174810",
            "telephone_number": "213-365-1000",
            "fax_number": "213-365-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EDWARD",
        "middle_name": "H.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4062",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "BK5973842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.