Individual provider Active NPI

Hayon Kim, O.D.

  • Optometrist
  • Baldwin Park, CA
National Provider Identifier
1881892743
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13256 Issued in CA
Practice address
3250 Big Dalton Ave
Baldwin Park, CA 91706-5107
Phone
(626) 851-8413
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13256 CA Primary

Addresses

Primary practice location

3250 Big Dalton Ave
Baldwin Park, CA 91706-5107

Mailing address

3250 Big Dalton Ave
Baldwin Park, CA 91706-5107
Phone (626) 851-8413

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
I20260403001787 CA Practitioner - Optometry 3678058377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3250 Big Dalton Ave
Baldwin Park, CA 91706-5107

PO Box
Suite 81
Grayslake, IL 60030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hayon Kim OD Inc Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1881892743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 BIG DALTON AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065107",
            "telephone_number": "626-851-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 BIG DALTON AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065107",
            "telephone_number": "626-851-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAYON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

Verify at the official NPI Registry.