Individual provider Active NPI

Jeffrey L. Kim, M.D.

  • Family Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1841453966
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A116545 Issued in CA
Practice address
25455 Barton Rd
Suite 204B
Loma Linda, CA 92354-3128
Phone
(909) 558-6600
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A116545 CA Primary
Family Medicine Physician 207Q00000X 0101280373 VA

Addresses

Primary practice location

25455 Barton Rd
Suite 204B
Loma Linda, CA 92354-3128

Mailing address

File # 54701
Los Angeles, CA 90074-4701
Phone (909) 651-4300

Other practice location 1

1001 E Leigh St
Richmond, VA 23298-5004
Phone (804) 828-5883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111128000478 CA Practitioner - Family Practice 6800060070 Reassigns benefits to 2 organizations
I20240821003177 VA Practitioner - Family Practice 6800060070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1001 E Leigh St
Richmond, VA 23298-5004
Phone (804) 828-7929

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116545CAMDMarriage & Family Therapist
A116545CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System CurrentSince Dec 10, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Dec 10, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Mar 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Mar 1, 2018 Accepting new patients
MCV Associated Physicians Family Medicine CurrentSince May 12, 2024 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
Ste 204B
Loma Linda, CA 92354
Phone (909) 558-6526

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

25828 Redlands Blvd
Ste 102
Redlands, CA 92373
Phone (909) 558-6856

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1001 E Leigh St
Richmond, VA 23298
Phone (804) 628-7497

Interoperability endpoints

  • Direct secure messaging: jkim2219@direct.llu.edu

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1841453966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE # 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-651-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD",
            "address_2": "SUITE 204B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543128",
            "telephone_number": "909-558-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 E Leigh St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985004",
            "country_code": "US",
            "telephone_number": "804-828-5883",
            "fax_number": "804-828-5399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEFFREY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A116545",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101280373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.