Individual provider Active NPI

Jane C Kim, M.D.

  • Neurology Physician
  • Sacramento, CA
National Provider Identifier
1871574772
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A92525 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-3514
Fax
(916) 734-6525
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A92525 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

4860 Y St
Suite 3700
Sacramento, CA 95817-2307
Phone (916) 734-3514

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20081119000777 CA Practitioner - Neurology 9032279161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Northwestern University Feinberg Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

4601 Dale Rd
Modesto, CA 95356-9718
Phone (209) 735-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A92525CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Dec 12, 2009 Accepting new patients
Golden Valley Health Center CurrentSince May 1, 2025 Accepting new patients
Golden Valley Health Centers CurrentSince May 1, 2025 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Golden Valley Health Centers Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Dec 12, 2009 Accepting new patients

Locations (25 of 33)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

1405 California Ave
Dos Palos, CA 93620
Phone (209) 392-2111

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

13161 Jefferson St
Le Grand, CA 95333
Phone (209) 389-1900

821 Texas Ave
Los Banos, CA 93635
Phone (209) 385-5481

250 Northgate Dr
Manteca, CA 95336
Phone (209) 239-5299

797 W Childs Ave
Merced, CA 95341
Phone (209) 383-5871

3940 Sandpiper Ave
Merced, CA 95340
Phone (209) 381-4104

847 W Childs Ave
Merced, CA 95341
Phone (209) 383-7441

1524 McHenry Ave
Ste 300
Modesto, CA 95350
Phone (209) 527-0615

1114 6th St
Modesto, CA 95354
Phone (209) 576-2845

4601 Dale Rd
Modesto, CA 95356
Phone (209) 557-1000

1121 Hammond St
Modesto, CA 95351
Phone (209) 576-4437

2101 Tenaya Dr
Modesto, CA 95354
Phone (209) 576-6766

1500 Florida Ave
Modesto, CA 95350
Phone (209) 571-5071

637 Merced St
Newman, CA 95360
Phone (209) 862-0270

1800 Harrison St
Fl 7
Oakland, CA 94612

200 C St
Patterson, CA 95363
Phone (209) 892-6307

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

9235 E Broadway St
Planada, CA 95365
Phone (209) 382-0253

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

4150 Patterson Rd
Riverbank, CA 95367
Phone (209) 863-3900

Organizations & group practices 6

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1871574772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "address_2": "SUITE 3700",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172307",
            "telephone_number": "916-734-3514",
            "fax_number": "916-734-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-3514",
            "fax_number": "916-734-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A92525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4601 Dale Rd",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953569718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.