Individual provider Active NPI

Danny Kim, M.D.

  • Ophthalmology Physician
  • Mission Hills, CA
National Provider Identifier
1700076551
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A109240 Issued in CA
Practice address
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone
(818) 365-9531
Fax
(818) 869-7242
NPI assigned
Jul 27, 2007
Last updated
Mar 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A109240 CA Primary

Addresses

Primary practice location

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5691

Other identifiers 1

IdentifierTypeStateIssuer
00A1092400MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091001000397 CA Practitioner - Ophthalmology 7911073838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, Davis School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

9111 Corbin Ave
Northridge, CA 91324-2402
Phone (818) 743-5700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109240CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Ophthalmology CurrentSince Aug 26, 2009 Accepting new patients
Providence Facey Medical Foundation CurrentSince Aug 26, 2009 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Dignity Community Care Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

17909 Soledad Canyon Rd
Santa Clarita, CA 91387
Phone (661) 250-5200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dkim350392@oc.providencedirect.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1700076551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5691",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 SEPULVEDA BLVD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451116",
            "telephone_number": "818-365-9531",
            "fax_number": "818-869-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANNY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A109240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1092400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.