Individual provider Active NPI

Wonae Kim, FNP

  • Family Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1508022450
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
622497 Issued in CA
Practice address
565 W Summerfield Cir
Anaheim, CA 92802-4782
Phone
(714) 928-5115
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 622497 CA Primary

Addresses

Primary practice location

565 W Summerfield Cir
Anaheim, CA 92802-4782

Mailing address

565 W Summerfield Cir
Anaheim, CA 92802-4782
Phone (714) 928-5115

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150511001360 CA Practitioner - Nurse Practitioner 8426377615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HMTS IncGroup PAC ID 1951750413, 118 clinicians

Practice addresses (Care Compare)

1190 Baker St
Suite 105
Costa Mesa, CA 92626-4105
Phone (714) 477-8460

15000 Kensington Park Dr
Suite 170
Tustin, CA 92782-1836
Phone (714) 477-8300

16205 Sand Canyon Ave
Suite 100
Irvine, CA 92618-3781
Phone (949) 557-0000

19582 Beach Blvd
Suite 180
Huntington Beach, CA 92648-5978
Phone (714) 477-8050

21115 Newport Coast Dr
Newport Beach, CA 92657-1122
Phone (949) 557-0730

26671 Aliso Creek Rd
Suite 101
Aliso Viejo, CA 92656-4807
Phone (949) 791-3107

49000 Barranca Pkwy
Suite 103
Irvine, CA 92604-8603
Phone (949) 791-3106

5341 Warner Ave
Huntington Beach, CA 92649-4078
Phone (714) 477-8450

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
622497CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Mar 1, 2019 Accepting new patients
HMTS, Inc CurrentSince Jan 1, 2024 Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

26671 Aliso Creek Rd
Ste 101
Aliso Viejo, CA 92656
Phone (949) 360-0330

19582 Beach Blvd
Ste 180
Huntington Beach, CA 92648
Phone (714) 477-8050

510 Superior Ave
Ste 290
Newport Beach, CA 92663
Phone (949) 764-4500

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 1

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1508022450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 W SUMMERFIELD CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928024782",
            "telephone_number": "714-928-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 W SUMMERFIELD CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928024782",
            "telephone_number": "714-928-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WONAE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "622497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.