Cherine Heesun Kim, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

A146773 Issued in CA

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(909) 558-8558

NPI assigned

Jun 9, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Loma Linda University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ckim64009@direct.llu.edu
• Direct secure messaging: ckim22442@epiclp.direct-ci.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.

• Beaver Medical Group P C

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319
  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment Care Compare group NPD
• Sac Health System

  dba SAC Arrowhead

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment NPD
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126

  Otolaryngology

  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1649547944

  Otolaryngology

  NPD
• Beaver Medical Group P C

  dba Beaver Advantage Health Center

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1275570830
  NPD (past)
• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)
• Loma Linda University Children's Hospital

  • Children's Hospital
  • Loma Linda, CA
  • NPI 1366866345
  NPD (past)
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)
• Lucile Salter Packard Children's Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1467442749
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  Care Compare affiliation

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1578943189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "909-558-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHERINE",
        "middle_name": "HEESUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A146773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A. Kidd, M.D.
• Christine Ann Kiedaisch, OTR L
• Kaitlin Elizabeth Kilian, NP
• Bora Kim, MD
• Charles Kim, PA
• Christine Kim, M.D.
• Daniel Kim, MD
• Daniel Sunwook Kim
• David Andrew Kim, MD
• Edward Eliot Kim, MD

• Otolaryngology Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.