Individual provider Active NPI

Michael K Kim, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Los Alamitos, CA
National Provider Identifier
1437198678
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
A86558 Issued in CA
Practice address
3801 Katella Ave
Suite 414
Los Alamitos, CA 90720-3338
Phone
(562) 430-6065
Fax
(562) 430-6069
NPI assigned
Jun 5, 2006
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X A86558 CA Primary

Addresses

Primary practice location

3801 Katella Ave
Suite 414
Los Alamitos, CA 90720-3338

Mailing address

3801 Katella Ave
Suite 414
Los Alamitos, CA 90720-3338
Phone (562) 430-6065

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
I20040618001356 CA Practitioner - Otolaryngology 4486639010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Temple University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3801 Katella Ave
Suite 414
Los Alamitos, CA 90720-3386
Phone (562) 430-6065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86558CAMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael K. Kim, M.D. Current Accepting new patients
Michael K. Kim, M.D., a Professional Corporation CurrentSince Sep 1, 2005 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

3801 Katella Ave
Ste 414
Los Alamitos, CA 90720
Phone (562) 430-6065

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1437198678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "SUITE 414",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-430-6065",
            "fax_number": "562-430-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "SUITE 414",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-430-6065",
            "fax_number": "562-430-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CA",
            "license": "A86558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.