Individual provider Active NPI

Michelle Jihae Kim, DPT

  • Physical Therapist
  • Irvine, CA
National Provider Identifier
1932861028
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT300550 Issued in CA
Practice address
15771 Rockfield Blvd Ste 150
Irvine, CA 92618-2846
Phone
(949) 750-8499
Fax
(949) 446-6294
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT300550 CA Primary

Addresses

Primary practice location

15771 Rockfield Blvd Ste 150
Irvine, CA 92618-2846

Mailing address

129 W Wilson St Ste 202
Costa Mesa, CA 92627-1586
Phone (949) 631-0125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211108000424 CA Practitioner - Physical Therapist in Private Practice 2466841754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Physical Therapy and Rehabilitation IncGroup PAC ID 6800857434, 6 clinicians

Practice addresses (Care Compare)

15771 Rockfield Blvd
Suite 150
Irvine, CA 92618-2846
Phone (949) 750-8499

Merit-based Incentive Payment System (MIPS)

Final score
82.66 of 100Reported as group
Quality
80
Improvement activities
40
Cost
68.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT300550CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physical Therapy and Rehabilitation Inc Physical Therapist CurrentSince Oct 13, 2021 Accepting new patients

Locations

129 W Wilson St
Ste 202
Costa Mesa, CA 92627
Phone (949) 631-0125

15771 Rockfield Blvd
Ste 150
Irvine, CA 92618
Phone (949) 750-8499

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1932861028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W WILSON ST STE 202",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271586",
            "telephone_number": "949-631-0125",
            "fax_number": "949-631-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15771 ROCKFIELD BLVD STE 150",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182846",
            "telephone_number": "949-750-8499",
            "fax_number": "949-446-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHELLE",
        "middle_name": "JIHAE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT300550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.