Individual provider Active NPI

Susan Kim, MD

  • Pediatric Rheumatology Physician
  • San Francisco, CA
National Provider Identifier
1417921586
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
C144819 Issued in CA
Practice address
505 Parnassus Ave
San Francisco, CA 94143-2204
Phone
(617) 355-6117
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 214160 MA
Pediatric Rheumatology Physician 2080P0216X 214160 MA
Pediatric Rheumatology Physician 2080P0216X C144819 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143-2204

Mailing address

505 Parnassus Ave
San Francisco, CA 94143-2204

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160929000750 CA Practitioner - RheumatologyPractitioner - Pediatric Medicine 2961415013 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
214160MAMDPediatrics Physician
C144819CAMDPediatric Rheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates Pediatrics CurrentSince Sep 7, 2016 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco CurrentSince Sep 7, 2016 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Sep 7, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 7, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 7, 2016 Accepting new patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Children'S Hospital Corporation Past Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1825 4th St
San Francisco, CA 94143
Phone (415) 353-3000

Interoperability endpoints

  • Direct secure messaging: skim80841@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1417921586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "617-355-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "214160",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MA",
            "license": "214160",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "CA",
            "license": "C144819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.