Individual provider Active NPI

Joanne J Kim, MD

  • Obstetrics & Gynecology Physician
  • Burlingame, CA
National Provider Identifier
1487790614
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A75392 Issued in CA
Practice address
1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone
(650) 652-8420
Fax
(650) 652-9440
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A75392 CA Primary

Addresses

Primary practice location

1501 Trousdale Dr
Burlingame, CA 94010-4506

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (415) 750-7050

Other practice location 1

1100 Van Ness Ave
San Francisco, CA 94109-6978
Phone (415) 750-7050

Other practice location 2

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (148) 779-0614

Other names 1

  • Koanne Jung Yun Kim Former name

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
I20100518000741 CA Practitioner - Obstetrics/Gynecology 5890824510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio State University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1100 Van Ness Ave
San Francisco, CA 94109-6978
Phone (415) 600-0140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75392CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Obstetrics & Gynecology Past Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

1501 Trousdale Dr
Fl 4
Burlingame, CA 94010
Phone (650) 652-6440

1501 Trousdale Dr
Burlingame, CA 94010
Phone (650) 696-3520

901 Campus Dr
Ste 311
Daly City, CA 94015
Phone (650) 756-8194

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

1100 Van Ness Ave
San Francisco, CA 94109
Phone (415) 600-5760

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2340 Clay St
#15
San Francisco, CA 94115

3838 California St
Rm 404
San Francisco, CA 94118
Phone (415) 600-0940

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

4000 Civic Center Dr
Ste 205
San Rafael, CA 94903
Phone (415) 479-7244

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

1551 Bishop St
Ste 110
Sn Luis Obisp, CA 93401
Phone (805) 548-8585

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: jkim150389@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1487790614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "415-750-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-652-8420",
            "fax_number": "650-652-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Van Ness Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941096978",
            "country_code": "US",
            "telephone_number": "415-750-7050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "795 El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943012302",
            "country_code": "US",
            "telephone_number": "148-779-0614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOANNE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A75392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOANNE",
            "last_name": "KIM",
            "middle_name": "JUNG YUN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.