Kenneth Kim, M.D

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

18733 Issued in CA

Practice address

17100 Euclid St.
Picu
Fountain Valley, CA 92708

Phone

(714) 966-7253

Fax

(714) 966-3354

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Pediatric Medicine

Education

George Washington University School of Medicine, 1992

Medicare assignment

May accept Medicare assignment

Group practices

Pokroy Medical Group of Nevada LTDGroup PAC ID 7911037643, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pokroy Medical Group of Nevada, LTD.

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
  • NPI 1992809412

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Summerlin Hospital Medical Center L L C

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831189638
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1922002468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST.",
            "address_2": "PICU",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-966-7253",
            "fax_number": "714-966-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST.",
            "address_2": "PICU",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-966-7253",
            "fax_number": "714-966-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KENNETH",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G077876",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "18733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chung Won Kim
• Ephraim Kim
• Jamie E Kim, M.D.
• Jeanie Lee Kim, WHNP
• Jiyoung Wittemore Kim
• Kirsten M Kim, PA-C
• Kristen Jane Kim
• Quy N Kim, DDS
• Stephanie Yonghee Kim, D.O.
• Sun Hui Kim

• Pediatric Critical Care Medicine Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.