Individual provider Active NPI

Caroline Theresa Kim

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1790461952
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025353 Issued in CA
Practice address
8010 Frost St
San Diego, CA 92123-2778
Phone
(858) 499-2600
NPI assigned
Jun 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025353 CA Primary

Addresses

Primary practice location

8010 Frost St
San Diego, CA 92123-2778

Mailing address

3131 Cauby St Apt 20
San Diego, CA 92110-4622
Phone (323) 351-6892

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928000751 CA Practitioner - Nurse Practitioner 5597119321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

8010 Frost St
FL 2
San Diego, CA 92123-4284
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95025353CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 18, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 18, 2023 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

8010 Frost St
Fl 2
San Diego, CA 92123
Phone (800) 827-4277

Interoperability endpoints

  • Direct secure messaging: ckim114255@sharphealthcare.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1790461952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 CAUBY ST APT 20",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104622",
            "telephone_number": "323-351-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 FROST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232778",
            "telephone_number": "858-499-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CAROLINE",
        "middle_name": "THERESA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.