Individual provider Active NPI

Jessica Nah-Hyung Kim, MD

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1477086866
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A157835 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-7016
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A157835 CA Primary
Pediatrics Physician 208000000X A157835 CA

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

101 The City Dr S
Orange, CA 92868-3201

Other practice location 1

1095 Irvine Blvd
Tustin, CA 92780-3526
Phone (714) 505-7110

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address jkim1991414@oc.providencedirect.org
Direct Messaging Address jkim1991414@oc.providencedirect.org
Direct Messaging Address jkim1991414@oc.providencedirect.org
Direct Messaging Address jkim1991414@oc.providencedirect.org

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
I20211027001541 CA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4284022039 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
University of Nevada School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 7416869516, 316 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157835CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Oct 1, 2021 Accepting new patients
UC Regents Current Accepting new patients
UC Regents CurrentSince Dec 1, 2023 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

2501 E Chapman Ave
Orange, CA 92869
Phone (714) 628-3300

2501 E Chapman Ave
Ste 207
Orange, CA 92869
Phone (714) 771-8177

1095 Irvine Blvd
Tustin, CA 92780
Phone (714) 505-7110

Organizations & group practices 8

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.

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1477086866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-7016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1095 Irvine Blvd",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803526",
            "country_code": "US",
            "telephone_number": "714-505-7110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "NAH-HYUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A157835",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157835",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkim1991414@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1095 Irvine Blvd",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927803526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkim1991414@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1100 W Stewart Dr",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928683849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkim1991414@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2501 E Chapman Ave",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928693204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkim1991414@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1095 Irvine Blvd",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927803526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.