Gina Kim In, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A168210 Issued in CA

Practice address

1450 10TH St Ste 404
Santa Monica, CA 90401-2831

Phone

(925) 282-1778

NPI assigned

Apr 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, CA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.ginain@148377.advancedmd-direct.com

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.

• Austin Travis County Mental Health and Mental Retardation Center

  • Psychiatry Physician
  • Austin, TX
  • NPI 1750337259
  Medicare reassignment NPD
• Baptist Physician Network

  • Specialist
  • Beaumont, TX
  • NPI 1558485532
  Medicare reassignment NPD
• Bluebonnet Trails Community MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
  • NPI 1730135864

  Psychiatry

  Medicare reassignment NPD
• Burke Center

  • Psychiatry Physician
  • Lufkin, TX
  • NPI 1396792420
  Medicare reassignment NPD
• Heart of Texas Region MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waco, TX
  • NPI 1639399132
  Medicare reassignment NPD
• Helen Farabee Centers

  • Community/Behavioral Health Agency
  • Wichita Falls, TX
  • NPI 1457479511

  Psychiatry

  Medicare reassignment NPD
• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA, Psychiatry

  Medicare reassignment NPD
• The Gulf Coast Center

  • Psychiatry Physician
  • League City, TX
  • NPI 1245285899
  Medicare reassignment NPD
• Camino Real Community MHMR Center

  • Case Management Agency
  • Lytle, TX
  • NPI 1154411262
  Medicare reassignment
• Austin Travis County Mental Health and Mental Retardation Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Austin, TX
  • NPI 1053632505
  NPD
• Bluebonnet Trails Community MHMR Center

  • Rural Health Clinic/Center
  • La Grange, TX
  • NPI 1518536309
  NPD
• Texana Center

  • Multi-Specialty Clinic/Center
  • Rosenberg, TX
  • NPI 1912954058
  NPD

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1861759672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 10TH ST STE 404",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 10TH ST STE 404",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012831",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Pierce St",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770028646",
            "country_code": "US",
            "telephone_number": "888-792-7122",
            "fax_number": "866-283-3450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11233 Shadow Creek Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775847367",
            "country_code": "US",
            "telephone_number": "832-757-1177",
            "fax_number": "832-460-6424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1480 64th St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Emeryville",
            "state": "CA",
            "postal_code": "946082267",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IN",
        "first_name": "GINA",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD.207359",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q4605",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A168210",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A168210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica Improta, LCSW
• Infortel Medical Group
• Infusion Connections Home Health Services, Inc.
• Infusion Connections Pharmacy Services Inc
• Eva Marie Inglizian, L.AC.
• Catherine Ann Inglove, MFT

• Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.