Individual provider Active NPI

Yeon Sun Kim, PA-C

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1811528623
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57938 Issued in CA
Practice address
2581 Samaritan Dr
San Jose, CA 95124-4113
Phone
(408) 357-6090
NPI assigned
Jan 30, 2020
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57938 CA Primary

Addresses

Primary practice location

2581 Samaritan Dr
San Jose, CA 95124-4113

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Other names 1

  • Christy Kim Other name

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
I20201120001837 CA Practitioner - Physician Assistant 0446661540 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

2500 Grant Rd
Mountain View, CA 94040-4302
Phone (650) 940-7000

2581 Samaritan Dr
San Jose, CA 95124-4112

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

701 E El Camino Real
Mountain View, CA 94040-2833
Phone (650) 691-6174

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57938CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Apr 24, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 24, 2023 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 24, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 24, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 24, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 24, 2023 Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3120 Kearney St
Fremont, CA 94538
Phone (650) 498-3600

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

715 Altos Oaks Dr
Los Altos, CA 94024
Phone (650) 934-7010

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

701 E El Camino Real
#1
Mountain View, CA 94040
Phone (650) 404-8440

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

301 Industrial Rd
#1
San Carlos, CA 94070
Phone (650) 404-8455

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2581 Samaritan Dr
San Jose, CA 95124
Phone (408) 357-6090

2581 Samaritan Dr
Ste 200
San Jose, CA 95124
Phone (408) 358-2030

2581 Samaritan Dr
Ste 308
San Jose, CA 95124
Phone (408) 355-1700

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: ykim656082@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1811528623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2581 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244113",
            "telephone_number": "408-357-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEON SUN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "KIM",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.