Jin Rian Kim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C55676 Issued in CA

Practice address

7000 Boulder Ave
Highland, CA 92346-3348

Phone

(909) 862-1191

Fax

(909) 793-2916

NPI assigned

Jul 27, 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA, IN, WI3 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 3

Specialty

Family Practice

Education

Medical College of Wisconsin, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Valley Emergency MedicineGroup PAC ID 7113412560, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sierra View Medical Center Hospital, Porterville, CA, CCN 050261

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Central Valley Emergency Medicine

  • Emergency Medical Services (Emergency Medicine) Physician
  • Porterville, CA
  • NPI 1336956275
  Medicare reassignment Care Compare group NPD
• Beaver Medical Group P C

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319
  Medicare reassignment NPD
• Chase Dennis Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Santa Rosa, CA
  • NPI 1033152350
  Medicare reassignment NPD
• Emergency Physicians Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1689963845
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  Family Medicine

  Medicare reassignment NPD
• Nes Western Group, a Professional Corporation

  • Emergency Medicine Physician
  • Porterville, CA
  • NPI 1487125019
  Medicare reassignment NPD
• Concord Company of Tennessee PLLC

  • Emergency Medicine Physician
  • Leitchfield, KY
  • NPI 1649743667

  IN

  Medicare reassignment NPD
• Froedtert Manitowoc Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment NPD
• Parkview Wabash Hospital, Inc.

  • Critical Access Hospital
  • Wabash, IN
  • NPI 1245259878
  Medicare reassignment NPD
• Putnam County Hospital

  • Critical Access Hospital
  • Greencastle, IN
  • NPI 1578608188
  Medicare reassignment NPD
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Emergency Physicians Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1629442728
  NPD

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

• Sierra View Local Health Care District

  • General Acute Care Hospital
  • Porterville, CA
  • NPI 1639143381
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1679597835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "920-835-1100",
            "fax_number": "920-835-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-862-1191",
            "fax_number": "909-793-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN",
        "middle_name": "RIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "41996",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C55676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMH NPI",
            "identifier": "1851477913",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32644100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11014110",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Jerome Kamiyama, O.D.
• Richard Kangah, MD
• Claire Kayitesi
• Corrie Keener, LMFT
• Martin Khairullah
• Judy Kim, B.S
• Kyu Hwan Kim, AC
• Nayeon Kim, DDS
• Soo Y Kim, M.D.
• Shawntel Kingstro

• Family Medicine Physician in Highland, CA
• Providers in Highland, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.