Paul Dong-Il Kim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53309 Issued in CA

Practice address

1742 Oregon St
Redding, CA 96001-1717

Phone

(530) 226-7419

Fax

(530) 262-6849

NPI assigned

Nov 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, 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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Native American Mental Health Services CorporationGroup PAC ID 5395072490, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Native American Mental Health Services Corporation

  dba North American Mental Health Services

  • Psychiatry Physician
  • Redding, CA
  • NPI 1073919171
  Medicare reassignment Care Compare group
• Rolling Hills Clinic

  • Federally Qualified Health Center (FQHC)
  • Red Bluff, CA
  • NPI 1679988950
  NPD (past)

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

{
    "created_epoch": "1448064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1447624911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 LARKSPUR LN",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020600",
            "telephone_number": "530-226-7419",
            "fax_number": "530-262-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 OREGON ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011717",
            "telephone_number": "530-226-7419",
            "fax_number": "530-262-6849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2865 Churn Creek Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960021117",
            "country_code": "US",
            "telephone_number": "530-646-7269",
            "fax_number": "530-275-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "middle_name": "DONG-IL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-21",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7659",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew J. Kilpatrick, MD
• Kim & Ole Jensen DC
• Kim & Ole Jensen DC (Shasta Spine Center)
• Hyungjoon Kim, DC
• Jessica Jung Yun Kim, MD
• Kimberly a. Page, M.D., Inc. (North Valley Neurosurgery)
• Renee Turner Kimbrell
• April Lynn Kimp, RDH
• John M Kimple, M.D.
• Kindness on-Time Transport, LLC

• Physician Assistant in Redding, CA
• Providers in Redding, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.