Amy Lynn Kim, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A102809 Issued in CA

Practice address

100 W California Blvd
Pasadena, CA 91105-3010

Phone

(626) 397-5000

Fax

(626) 397-2912

NPI assigned

Feb 26, 2007

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

Other identifiers 2

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

Anesthesiology

Education

Saint Louis University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Valley Medical GroupGroup PAC ID 3577465368, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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 Valley Medical Group

  • Anesthesiology Physician
  • Pasadena, CA
  • NPI 1851312862
  Medicare reassignment Care Compare group NPD
• Huntington Hospital Association

  • General Acute Care Hospital
  • Huntington, NY
  • NPI 1508845322
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1588790315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S LAKE AVE STE 535",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013010",
            "telephone_number": "626-795-9596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-5000",
            "fax_number": "626-397-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A102809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588790315",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0A1028090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda James Kiely, RN, IBCLC
• Robin Marie Kietzman, PHD
• Taline Ardaches Kilaghbian, M.D.
• Adina Kim, MSW
• Alice S Kim, MD
• Andrew Dong-Wook Kim
• Angela Sunmin Kim, FNP
• Angie Byung Ju Kim, PA-C
• Ashlee Kim, MFT
• Bo K Kim, MD

• Anesthesiology Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.