Individual provider Active NPI

John H Kim, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1821441551
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95134782 Issued in CA
Practice address
150 UCLA Medical Plaza 4TH Floor RNPH (4-East)
Los Angeles, CA 90095-5518
Phone
(310) 825-9989
Fax
(269) 210-2477
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95134782 CA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5010017 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 709540 NY

Addresses

Primary practice location

150 UCLA Medical Plaza 4TH Floor RNPH (4-East)
Los Angeles, CA 90095-5518

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190130000108 DC Practitioner - Nurse Practitioner 5698012615 Reassigns benefits to 1 organization
I20190204000210 VA Practitioner - Nurse Practitioner 5698012615 Reassigns benefits to 1 organization
I20210730000461 CA Practitioner - Nurse Practitioner 5698012615 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
76.01
Promoting interoperability
100
Improvement activities
40
Cost
56.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5010017NCMDPsychiatric/Mental Health Nurse Practitioner
709540NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2019 Accepting new patients
Matthew Wong MD, Inc CurrentSince Jul 30, 2021 Accepting new patients
Korean Health, Education, Information and Research Center CurrentSince Jun 14, 2022 Accepting new patients
Manolito B. Fidel, M.D., Inc CurrentSince Jul 30, 2021 Accepting new patients
Korean Health Education Information and Research Center CurrentSince Jun 14, 2022 Accepting new patients
Inova Health Care Services CurrentSince Jan 1, 2019 Accepting new patients
UC Regents CurrentSince Apr 1, 2021 Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

3727 W 6th St
Ste 210
Los Angeles, CA 90020
Phone (213) 235-2500

3727 W 6th St
Ste 200
Los Angeles, CA 90020
Phone (213) 235-2500

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

3255 Wilshire Blvd
Ste 120
Los Angeles, CA 90010
Phone (213) 235-1212

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

23700 Camino del Sol
Torrance, CA 90505
Phone (310) 530-1151

2740 Prosperity Ave
Ste 200
Fairfax, VA 22031
Phone (703) 208-2273

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jkim901672@direct.uclahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1821441551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 UCLA MEDICAL PLAZA 4TH FLOOR RNPH (4-EAST)",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900955518",
            "telephone_number": "310-825-9989",
            "fax_number": "269-210-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95134782",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5010017",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "709540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.