Individual provider Active NPI

Esther Won Kim, OD

  • Optometrist
  • Las Vegas, NV
National Provider Identifier
1902428345
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34532 Issued in CA
Practice address
230 N Nellis Blvd
Las Vegas, NV 89110-6002
Phone
(702) 452-2020
NPI assigned
May 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34532 CA Primary

Addresses

Primary practice location

230 N Nellis Blvd
Las Vegas, NV 89110-6002

Mailing address

14 Julian
Irvine, CA 92602-2427
Phone (949) 933-9444

Other practice location 1

2295 Kietzke Ln
Reno, NV 89502-3604
Phone (949) 933-9444

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201009001498 NV Practitioner - Optometry 2466872635 Reassigns benefits to 2 organizations
I20211103003008 CA Practitioner - Optometry 2466872635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

2055 Kellogg Ave
Corona, CA 92879-3111
Phone (866) 984-7483

22550 Savi Ranch Pkwy
Yorba Linda, CA 92887-4670
Phone (714) 685-3500

23781 Maquina
Mission Viejo, CA 92691-2716
Phone (888) 988-2800

5 Centerpointe Dr
La Palma, CA 90623-1050
Phone (888) 988-2800

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kopolow & Girisgen Professional Corporation Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 23, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 5, 2024 Accepting new patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 23, 2021 Accepting new patients
Girisgen & Kopolow OD, PC Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Girisgen & Kopolow OD, PC Optometrist Current Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

75 S Valle Verde Dr
Ste 120
Henderson, NV 89012

7361 W Lake Mead Blvd
Ste 104
Las Vegas, NV 89128
Phone (702) 341-7254

4045 Spencer St
Ste A59
Las Vegas, NV 89119
Phone (702) 437-5521

5465 Meadowood Mall Cir
Reno, NV 89502
Phone (775) 826-4100

Organizations & group practices 9

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": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1902428345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 JULIAN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926022427",
            "telephone_number": "949-933-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N NELLIS BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891106002",
            "telephone_number": "702-452-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2295 Kietzke Ln",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895023604",
            "country_code": "US",
            "telephone_number": "949-933-9444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ESTHER",
        "middle_name": "WON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-08",
        "last_updated": "2021-12-08",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.