NPIMap

Individual provider Active NPI

Keun-Young Anthony Kim, M.D.

  • Neurological Surgery Physician
  • Mission Viejo, CA
National Provider Identifier
1659577286
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A79340 Issued in CA
Practice address
26732 Crown Valley Parkway
Suite #541
Mission Viejo, CA 92691
Phone
(949) 388-7190
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A79340 CA Primary

Addresses

Primary practice location

26732 Crown Valley Parkway
Suite #541
Mission Viejo, CA 92691

Mailing address

26732 Crown Valley Parkway
Suite #541
Mission Viejo, CA 92691
Phone (949) 388-7190

Other names 1

  • Dr. Anthony Kim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071018000793 CA Practitioner - Neurosurgery 3173619350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

26732 Crown Valley Pkwy
Suite 541
Mission Viejo, CA 92691-6376
Phone (949) 388-7190

Hospital & facility affiliations

  • Providence at Home With Compassus Home Health Orange County Home health agency, Anaheim, CA, CCN 057600
  • Providence at Home With Compassus Home Health, Orange County South Home health agency, Irvine, CA, CCN 058238
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion91
Laminectomy or laminotomy (partial removal of spine bones)14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A79340CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Doctors CurrentSince Oct 1, 2018 Accepting new patients
Anthony Kim MD a Medical Corporation Neurological Surgery CurrentSince Jul 19, 2007 Accepting new patients
United Medical Doctors CurrentSince Oct 1, 2018 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

16405 Sand Canyon Ave
Ste 250
Irvine, CA 92618
Phone (949) 502-5572

26732 Crown Valley Pkwy
Ste 541
Mission Viejo, CA 92691
Phone (949) 388-7190

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kkim1372864@oc.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1659577286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PARKWAY",
            "address_2": "SUITE #541",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-388-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PARKWAY",
            "address_2": "SUITE #541",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-388-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEUN-YOUNG",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A79340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "M.D.INC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.