Ronald Sungsoo Kim, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95019960 Issued in CA

Practice address

1 Hope Dr
Tustin, CA 92782-0221

Phone

(713) 247-0300

NPI assigned

Feb 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADEBAA

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.

• Hurtt Family Health Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1306965587
  Medicare reassignment NPD
• Hurtt Family Health Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1144760943
  NPD
• Hurtt Family Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Ana, CA
  • NPI 1003250093
  NPD (past)

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1871248286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "713-247-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "713-247-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RONALD",
        "middle_name": "SUNGSOO",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelvin Kim, STUDENT
• Kyung Myun Kim, D.D.S.
• Lulu Y Kim, OD
• Maria Kim, M.D.
• Paul J. Kim, M.D.
• Ryon Kim, LAC
• Sung-Woong Kim, M.D.
• Sunnam Kim, L.AC.
• Susie Kim, MD
• Taehyang Kim, LA.C

• Family Nurse Practitioner in Tustin, CA
• Providers in Tustin, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.