John Jin Kim, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A111549 Issued in CA

Practice address

1900 E Washington St
Colton, CA 92324-4614

Phone

(909) 825-3425

Fax

(909) 825-6991

NPI assigned

Sep 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Ophthalmology

Education

Icahn School of Medicine at Mount Sinai, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Eye Institute a Medical Group IncGroup PAC ID 7911966122, 43 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.15 of 100Reported as group

Quality

76.08

Promoting interoperability

72

Improvement activities

40

Cost

75.13

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pacific Eye Institute, a Medical Group, Inc.

  • Ophthalmology Physician
  • Upland, CA
  • NPI 1962422709
  Medicare reassignment Care Compare group NPD
• Eyecare Medical Corporation

  • Ophthalmology Physician
  • Buena Park, CA
  • NPI 1427016120
  Medicare reassignment NPD
• William D. Mosier, M.D., Inc., a Professional Medical Corporation

  • Ophthalmology Physician
  • Fullerton, CA
  • NPI 1003476508
  Medicare reassignment NPD
• Eyecare Medical Corporation

  • Ophthalmology Physician
  • Artesia, CA
  • NPI 1932580198
  NPD
• Ayad M Gharghoury MD Inc

  • Specialist
  • Yucca Valley, CA
  • NPI 1427390418
  NPD (past)
• Chino Medical Group, Inc

  • Health Maintenance Organization
  • Chino, CA
  • NPI 1790730786
  NPD (past)

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1508050220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E WASHINGTON ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244614",
            "telephone_number": "909-825-3425",
            "fax_number": "909-825-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E WASHINGTON ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244614",
            "telephone_number": "909-825-3425",
            "fax_number": "909-825-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "middle_name": "JIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A111549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508050220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Maria Kim
• Edwin Kim, MD
• Eleanor Kim, DO
• James Min Kim, M.D.
• Jiensup Kim, M.D.
• Katie Joohee Kim
• Keun-Suh Kim
• So Un Kim
• Soyoung L Kim, DDS
• William Kim

• Ophthalmology Physician in Colton, CA
• Providers in Colton, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.