Tai-Won Kim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C50240 Issued in CA

Practice address

7212 Orangethorpe Avenue,
Suite 9a
Buena Park, CA 90621-4668

Phone

(714) 503-6550

Fax

(714) 409-3075

NPI assigned

Nov 6, 2006

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

Other identifiers 3

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

Specialty

Internal Medicine

Education

Other, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KCS, Inc.Group PAC ID 0446495105, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: taiwon.kim.p1@direct.kcs.nextgenshare.com

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.

• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1861525602
  Medicare reassignment Care Compare group NPD
• Hanmaum Medical Center

  • Multi-Specialty Clinic/Center
  • Laguna Woods, CA
  • NPI 1912883315

  Internal Medicine

  Medicare reassignment NPD
• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1992951180
  NPD
• Anaheim Memorial Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1295782381
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1487733754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 WEST LINCOLN AVENUE",
            "address_2": "SUITE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052912",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 ORANGETHORPE AVENUE,",
            "address_2": "SUITE 9A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906214668",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAI-WON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C50240",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "37571",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330654",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487733754",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "35037571",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• So H Kim
• Soohyun Kim
• Stephen Kim, DDS
• Sueyon Kim, CCC-SLP
• Sung Hyun Kim, M.D
• Yejin Kim, DDS
• Yong Ook Kim, LAC
• Young DO Kim, LAC
• Young Rae Kim, DPT
• Young Ryul Kim, DDS

• Internal Medicine Physician in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.