Andrew C Kim, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

M-1786 Issued in GU

Practice address

Mad River Orthopaedics & Sports Medicine
3798 Janes Road Suite 5
Arcata, CA 95521

Phone

(707) 826-8244

Fax

(707) 826-8252

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, GU2 enrollments

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 2

Specialty

Orthopedic Surgery

Education

Loma Linda University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Pacific Cardiology Medical 21 clinicians

Guam Memorial Hospital 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
• Guam Memorial Hospital Authority Hospital, Tamuning, GU, CCN 650001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.kim@adventistclinic.directbygreenway.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.

• North Pacific Cardiology Medical

  • Internal Medicine Physician
  • Arcata, CA
  • NPI 1093821837

  CA

  Medicare reassignment Care Compare group NPD
• Guam Memorial Hospital

  • General Acute Care Hospital
  • Oka Tamuning, GU
  • NPI 1366519027

  GU

  Medicare reassignment Care Compare group NPD
• General Conference Corp of Sda

  • Clinic/Center
  • Tamuning, GU
  • NPI 1275586877

  GU

  Medicare reassignment NPD
• Guam Healthcare Development Incorporated

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939

  GU

  Medicare reassignment NPD
• Guam Memorial Hospital

  • Skilled Nursing Facility
  • Oka Tamuning, GU
  • NPI 1952479131
  Care Compare group NPD

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

• American Hospital Management Corporation

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635

  Hospital

  Care Compare affiliation
• Guam Memorial Hospital

  • General Acute Care Hospital
  • Oka Tamuning, GU
  • NPI 1366519027

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1609978618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUAM SDA CLINIC. 388 YPAO RD.",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-646-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAD RIVER ORTHOPAEDICS & SPORTS MEDICINE",
            "address_2": "3798 JANES ROAD SUITE 5",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "95521",
            "telephone_number": "707-826-8244",
            "fax_number": "707-826-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-06-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G45641",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GU",
            "license": "M-1786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.kim@adventistclinic.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "388 Ypao Rd",
            "city": "Tamuning",
            "state": "GU",
            "country_code": "US",
            "postal_code": "969133701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Louis Kennedy, M.D.
• Hugh Kent, MD
• Stacey Diane Kett, LAC
• Kristen Nicole Ketterman, MA, AMFT
• Cynthia Rose Kiehn-Mola, MA & PPS CREDENTAIL
• Hanna Kim
• Sang Won Kim
• Martin Kimble, PA
• Anyamay King Gunning
• Susana King, RN

• All providers in Arcata, CA
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.