Individual provider Active NPI

Julie Cheon Kim, O.D.

  • Optometrist
  • Huntington Beach, CA
National Provider Identifier
1881882223
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14387T Issued in CA
Practice address
7562 Center Ave
Huntington Beach, CA 92647-3002
Phone
(714) 372-7525
NPI assigned
Oct 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.010036 IL
Optometrist 152W00000X 14387T CA Primary

Addresses

Primary practice location

7562 Center Ave
Huntington Beach, CA 92647-3002

Mailing address

PO Box 54851
Irvine, CA 92619-4851

Other practice location 1

221 S Vermont Ave
Los Angeles, CA 90004-5906
Phone (213) 388-7020

Other practice location 2

221 S Vermont Ave
Los Angeles, CA 90004-5906
Phone (213) 388-7020

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201002088 CA Practitioner - Optometry 9931297843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Martin Doll OD IncGroup PAC ID 2961633185, 3 clinicians

Practice addresses (Care Compare)

7562 Ctr Ave
Huntington Beach, CA 92647-3002
Phone (714) 372-7525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14387TCAMDOptometrist
046.010036ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc Past Accepting new patients
Visionworks, Inc. Optometrist PastSince Mar 17, 2018 Accepting new patients

Organizations & group practices 3

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": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1881882223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54851",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926194851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7562 CENTER AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473002",
            "telephone_number": "714-372-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900045906",
            "country_code": "US",
            "telephone_number": "213-388-7020",
            "fax_number": "213-388-7022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900045906",
            "country_code": "US",
            "telephone_number": "213-388-7020",
            "fax_number": "213-388-7022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JULIE",
        "middle_name": "CHEON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010036",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14387T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.