Individual provider Active NPI

Matthew H Kim, M.D.

  • Ophthalmology Physician
  • Fullerton, CA
National Provider Identifier
1770514465
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A94998 Issued in CA
Practice address
270 Laguna Rd
Suite 100
Fullerton, CA 92835-2521
Phone
(714) 525-2375
Fax
(714) 871-9280
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 A94998 CA Primary

Addresses

Primary practice location

270 Laguna Rd
Suite 100
Fullerton, CA 92835-2521

Mailing address

270 Laguna Rd
Suite 100
Fullerton, CA 92835-2521
Phone (714) 525-2375

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
I20060831000303 CA Practitioner - Ophthalmology 9436153681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Creighton University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brilliant Eye CenterGroup PAC ID 0345271821, 4 clinicians

Practice addresses (Care Compare)

270 Laguna Rd
Suite 100
Fullerton, CA 92835-2521
Phone (714) 525-2375

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery229

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94998CAMDClinical Social Worker
A94998CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brilliant Eye Center Ophthalmology CurrentSince Aug 1, 2007 Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

270 Laguna Rd
Ste 100
Fullerton, CA 92835
Phone (714) 525-2375

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 2

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1770514465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 LAGUNA RD",
            "address_2": "SUITE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352521",
            "telephone_number": "714-525-2375",
            "fax_number": "714-871-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 LAGUNA RD",
            "address_2": "SUITE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352521",
            "telephone_number": "714-525-2375",
            "fax_number": "714-871-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MATTHEW",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A94998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.