Active NPI
Joyce Kim, O.D
- Optometrist
- Sunnyvale, CA
National Provider Identifier
1366411613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7401
- Practice address
- 1021 S. Wolfe Rd
Suite 145
Sunnyvale, CA 94086-8880 - Phone
- (408) 737-7007
- NPI assigned
- Mar 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7401 | CA | Primary |
Addresses
Primary practice location
1021 S. Wolfe Rd
Suite 145
Sunnyvale, CA 94086-8880
Mailing address
1021 S. Wolfe Rd
Suite 145
Sunnyvale, CA 94086-8880
Phone (408) 737-7007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0074010 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111230000117 | CA | Practitioner - Optometry | 3779759469 | Practice locations: Sunnyvale, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1021 S Wolfe Rd
Suite 1456
Sunnyvale, CA 94086-8806
Phone (408) 737-7007
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1366411613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 S. WOLFE RD",
"address_2": "SUITE 145",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940868880",
"telephone_number": "408-737-7007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 S. WOLFE RD",
"address_2": "SUITE 145",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940868880",
"telephone_number": "408-737-7007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOYCE",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-17",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7401",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0074010",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.