Active NPI
Jeffrey David Kim, M.D.
- Family Medicine Physician
- Carpinteria, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C161734
- Practice address
- 4806 Carpinteria Ave
Carpinteria, CA 93013-1935 - Phone
- (805) 566-5080
- NPI assigned
- Mar 20, 2007
- Last updated
- Sep 21, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C161734 | CA | Primary |
| Family Medicine Physician | 207Q00000X | 5029 | AK |
Addresses
Primary practice location
4806 Carpinteria Ave
Carpinteria, CA 93013-1935
Mailing address
470 S Patterson Ave
Santa Barbara, CA 93111-2404
Other practice location 1
2211 E Northern Lights Blvd
Medical Park Family Care
Anchorage, AK 99508-4129
Phone (907) 279-8486
Other practice location 2
2211 E Northern Lights Blvd
Medical Park Family Care
Anchorage, AK 99508-4129
Phone (907) 279-8486
Other practice location 3
3801 University Lake Dr Ste 301
Anchorage, AK 99508
Phone (907) 777-1850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD45685 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Boston University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
122 S Patterson Ave
Santa Barbara, CA 93111-2077
Phone (805) 681-1733
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5029 | AK | MD | Family Medicine Physician |
| C161734 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sansum Clinic | Current | Accepting new patients | |
| Sansum Clinic | Current | Accepting new patients | |
| Alaska Center for Pediatrics, LLC | Current | Accepting new patients | |
| Arete Family Care LLC | Family Medicine | Current | Accepting new patients |
| Sansum Clinic | Current | Accepting new patients | |
| Providence Health & Services Washington | Past | Accepting new patients | |
| Sansum Clinic | Past | Accepting new patients | |
| Santa Barbara Cottage Hospital | Past | Accepting new patients | |
| Sansum Clinic | Past | Accepting new patients | |
| Galen Hospital Alaska, Inc. | Past | Accepting new patients |
Locations
2925 Debarr Rd
Ste 230
Anchorage, AK 99508
Phone (907) 777-1800
3801 University Lake Dr
Ste 301
Anchorage, AK 99508
Phone (907) 777-1850
4806 Carpinteria Ave
Carpinteria, CA 93013
Phone (805) 566-5077
122 S Patterson Ave
Santa Barbara, CA 93111
Phone (805) 681-1733
215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765
Interoperability endpoints
- https://api.platform.athenahealth.com/24116/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/9493/brand/2/csg/1/fhir/r4
Organizations & group practices 10
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.
-
- Multi-Specialty Clinic/Center
- Santa Barbara, CA
- NPI 1154354504
-
- Multi-Specialty Clinic/Center
- Anchorage, AK
- NPI 1659581635
-
- Ambulatory Surgical Clinic/Center
- Santa Barbara, CA
- NPI 1144648015
-
- Multi-Specialty Clinic/Center
- Santa Barbara, CA
- NPI 1932121514
-
- Family Medicine Physician
- Anchorage, AK
- NPI 1801460415
-
- Ambulatory Surgical Clinic/Center
- Santa Barbara, CA
- NPI 1649296807
-
- General Acute Care Hospital
- Santa Barbara, CA
- NPI 1477554152
-
dba Alaska Regional Hospital
- General Acute Care Hospital
- Anchorage, AK
- NPI 1811941883
-
dba Providence Alaska Medical Center
- General Acute Care Hospital
- Anchorage, AK
- NPI 1053363119
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- San Luis Obispo, CA
- NPI 1609044924
-
- Home Health Agency
- Santa Barbara, CA
- NPI 1477560035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1659496339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 S PATTERSON AVE",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931112404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4806 CARPINTERIA AVE",
"city": "CARPINTERIA",
"state": "CA",
"postal_code": "930131935",
"telephone_number": "805-566-5080"
}
],
"practiceLocations": [
{
"address_1": "2211 E Northern Lights Blvd",
"address_2": "Medical Park Family Care",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "995084129",
"country_code": "US",
"telephone_number": "907-279-8486",
"fax_number": "907-257-8196",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2211 E Northern Lights Blvd",
"address_2": "Medical Park Family Care",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "995084129",
"country_code": "US",
"telephone_number": "907-279-8486",
"fax_number": "907-257-8196",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3801 University Lake Dr Ste 301",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "99508",
"country_code": "US",
"telephone_number": "907-777-1850",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "JEFFREY",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C161734",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "5029",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD45685",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carpinteria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.