Individual provider Active NPI

Alexander S Kim, M.D.

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • La Jolla, CA
National Provider Identifier
1841429404
Registry record updated Jun 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X
License
125086 Issued in CA
Practice address
9500 Gilman Dr Dept 635
La Jolla, CA 92093-0635
Phone
(619) 335-8685
NPI assigned
Jul 3, 2009
Last updated
Jun 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Immunology (Allergy & Immunology) Physician 207KI0005X 125086 CA Primary
Internal Medicine Physician 207R00000X P0989 TX

Addresses

Primary practice location

9500 Gilman Dr Dept 635
La Jolla, CA 92093-0635

Mailing address

9500 Gilman Dr Dept 635
La Jolla, CA 92093-0635
Phone (619) 335-8685

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
I20150715002625 CA Practitioner - Allergy/Immunology 5698088912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

16950 Via Tazon
San Diego, CA 92127-1607
Phone (800) 926-8273

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

8899 University Ctr LN
Suite 400
San Diego, CA 92122-1010
Phone (800) 926-8273

8899 University Lane
San Diego, CA 92122-1010
Phone (858) 657-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125086CAMDClinical & Laboratory Immunology (Allergy & Immunology) Physician
P0989TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Clinical & Laboratory Immunology CurrentSince Jul 1, 2015 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2015 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 5

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 1

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": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433635200000",
    "number": "1841429404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR DEPT 635",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930635",
            "telephone_number": "619-335-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR DEPT 635",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930635",
            "telephone_number": "619-335-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALEXANDER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-03",
        "last_updated": "2015-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "CA",
            "license": "125086",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P0989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.