Evan Yung Jin Kim, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A13764 Issued in CA

Practice address

801 S Chevy Chase Dr Ste 201
Glendale, CA 91205-4435

Phone

(818) 500-5586

NPI assigned

Jan 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

SMG Medical Practice Group PCGroup PAC ID 8921578220, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: evan.kim@846495524519940.direct.elationemr.com

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.

• Adventist Health Physicians Network

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1083976294
  Medicare reassignment Care Compare group NPD
• SMG Medical Practice Group PC

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1710660659
  Medicare reassignment Care Compare group
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Urgent Care Clinic/Center
  • Moorpark, CA
  • NPI 1992244503
  NPD
• Cha Hollywood Medical Center, LP

  dba Hollywood Presbyterian Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  NPD (past)
• Family Practice of Glendale a Medical Corporation

  dba Family Medicine Center and Descanso Family Practice

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1801851043
  NPD (past)

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1790175859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR STE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054435",
            "telephone_number": "818-500-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EVAN",
        "middle_name": "YUNG JIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-28",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A13764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Kim
• Dong Kim, D.C.
• Edward I Kim, D.D.S.,M.S.
• Elaine Lee Kim, RD
• Erica Kim
• Isabel Kim
• Janice Park Kim, M.D.
• Jia Kim
• Julia Kim, DO
• Julie Kim, OTR/L

• Family Medicine Physician in Glendale, CA
• Providers in Glendale, 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 Aug 23, 2022; 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.