Ji Eun Kim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA67248 Issued in CA

Practice address

1500 San Pablo St FL 4
Los Angeles, CA 90033-5313

Phone

(323) 442-7400

NPI assigned

Dec 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Genie Kim Other name

Medicare fee-for-service enrollment

Enrolled in MN, CA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1922074434
  Medicare reassignment Care Compare group
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Mayo Clinic

  • Multi-Specialty Clinic/Center
  • Rochester, MN
  • NPI 1881018208
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Hospital-Rochester

  • General Acute Care Hospital
  • Rochester, MN
  • NPI 1841266194
  Care Compare affiliation

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1386065092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50938",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740938",
            "telephone_number": "323-442-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1222 E Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Barron",
            "state": "WI",
            "postal_code": "548121765",
            "country_code": "US",
            "telephone_number": "715-537-3166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4367 NW American Ln",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320554828",
            "country_code": "US",
            "telephone_number": "386-758-6094",
            "fax_number": "386-243-8152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI EUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056549",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107704",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13716",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67248",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENIE",
            "last_name": "KIM",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jessica Kim
• Jessica Mifa Kim, LMFT
• Jessie Kim
• Ji Ae Janice Kim, FNP-BC
• Ji Ah Kim, CRNA
• Ji Hye Kim
• Ji Hye Kim
• Ji Soo Kim, PA
• Ji Sun Kim, ACUPUNCTURIST
• Ji Yeon Kim, PHARM.D

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.