Tae Sun Kim, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G81760 Issued in CA

Practice address

11829 South St
Suite 202
Cerritos, CA 90703-6828

Phone

(562) 402-4720

Fax

(562) 402-9231

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

Tufts University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

94

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Cerritos Eye Medical Center, Inc.

  • Ophthalmology Physician
  • Cerritos, CA
  • NPI 1598792889
  Medicare reassignment Authorized official
• Los Alamitos Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Los Alamitos, CA
  • NPI 1497780084
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366578049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11829 SOUTH ST",
            "address_2": "SUITE 202",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036828",
            "telephone_number": "562-402-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11829 SOUTH ST",
            "address_2": "SUITE 202",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036828",
            "telephone_number": "562-402-4720",
            "fax_number": "562-402-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAE",
        "middle_name": "SUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G81760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mina Mariela Kim
• Mindy Kim
• Paul Kim
• Paul Kwansoo Kim, DMD
• Susan Haiweon Kim, D.M.D
• Teresa Jiwon Kim, NP
• Violeta Kim, LCSW
• Woo Jung Kim
• Yooron Kim
• Maria C King

• Ophthalmology Physician in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.