Jiyoung Kim, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

16991 Issued in CA

Practice address

3801 Miranda Ave # 171
Palo Alto, CA 94304-1290

Phone

(650) 493-5000

Fax

(650) 858-8905

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ji Young Kim Former name

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• GN Medical Associates, Inc.

  dba Gerinet Medical Associates

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1275576522

  Gerontology

  NPD (past)
• Rivera Sanatarium Inc

  dba Colonial Gardens Nursing Home

  • Skilled Nursing Facility
  • Pico Rivera, CA
  • NPI 1861580029
  NPD (past)
• Mobile Medical & Nursing, Inc.

  • Nurse Practitioner
  • Palm Beach Gardens, FL
  • NPI 1023123940
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1942427927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE # 171",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "650-493-5000",
            "fax_number": "650-858-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE # 171",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "650-493-5000",
            "fax_number": "650-858-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIYOUNG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "16991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JI YOUNG",
            "last_name": "KIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hyunmi Kim, MD, PHD
• Isaac Elijah Kim Jr., MD, PHD
• Jennifer Kim, MD
• Jinah Kim, M.D., PH.D.
• Jiyoung Kim, MLS
• Jonathan Wonwook Kim, MD
• Joseph Ji-Ho Kim, MD
• Judith Sunah Kim, PHARMD
• Juliana Eunyoung Kim, MD
• Juliann Kim, MD

• Gerontology Nurse Practitioner in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.