Stella Kim

Primary specialty

OptometristTaxonomy code 152W00000X

License

14985TLG Issued in CA

Practice address

2225 E Garvey Ave N Ste a
West Covina, CA 91791-1500

Phone

(266) 009-4866

NPI assigned

Jul 2, 2014

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stella.kim.p1@direct.fhccgla.nextgenshare.com

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Korean Health Education Information and Research Center

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1396329199

  Corporate Officer

  CMS ownership
• Korean Health Education Information and Research Center

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1437377454

  W-2 Managing Employee

  CMS ownership
• Korean Health Education Information and Research Center

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1902568330

  Corporate Officer

  CMS ownership
• Korean Health, Education, Information and Research Center

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1013311448

  Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Children's Eye Institute, Inc.

  • Ophthalmology Physician
  • Upland, CA
  • NPI 1043221922
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Korean Health, Education, Information and Research Center

  dba Kheir Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1093562589
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1508272253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 E ARROW HWY STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864955",
            "telephone_number": "909-931-9675",
            "fax_number": "909-931-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E GARVEY AVE N STE A",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911500",
            "telephone_number": "266-009-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14985TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heidi Weizhang Kim, DDS
• Jae M Kim, M.D.
• Jennifer Young Kim, MD
• Jeong E. Kim, DDS
• Jung Hoon Kim, PHARM.D.
• Young Woo Kim, DDS
• Elizabeth Kintner, M.S.M.F.T.
• Emily Ann Kitley
• Jeffrey S Klein, CCC-SLP
• Phyllis H Klein, M.D.

• Optometrist in West Covina, CA
• Providers in West Covina, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.