Individual provider Active NPI

Kacie Kyungsun Paik, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1942798509
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A165648 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(629) 543-6268
NPI assigned
Apr 28, 2018
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A165648 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

14350 Meridian Pkwy # 2
Riverside, CA 92518-3035
Phone (951) 827-7669

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220119001277 CA Practitioner - Family Practice 4880086107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4310 Orange St
Riverside, CA 92501-3829
Phone (951) 781-6335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Family Physicians, a Professional Medical Corporation Family Medicine CurrentSince Jan 12, 2022 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Cardiology Specialists Medical Group, Inc. PastSince Jan 12, 2022 Accepting new patients

Locations

4244 Riverwalk Pkwy
Ste 150
Riverside, CA 92505
Phone (951) 335-4660

4310 Orange St
Riverside, CA 92501
Phone (951) 781-6335

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kacie.paik.p1@direct.famdoc.nextgenshare.com
  • Direct secure messaging: kacie.paik.p2@direct.famdoc.nextgenshare.com

Organizations & group practices 3

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": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1942798509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14350 MERIDIAN PKWY # 2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925183035",
            "telephone_number": "951-827-7669",
            "fax_number": "951-827-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "629-543-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIK",
        "first_name": "KACIE",
        "middle_name": "KYUNGSUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-28",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A165648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.