Elden H. Kim, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95024265 Issued in CA

Practice address

4766 Calcagno CT
Dublin, CA 94568-4264

Phone

(415) 961-4555

NPI assigned

Feb 14, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pacific Family Medicine Clinic Inc

  • Specialist
  • Millbrae, CA
  • NPI 1356723605
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1942907514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4766 CALCAGNO CT",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945684264",
            "telephone_number": "415-961-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4766 CALCAGNO CT",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945684264",
            "telephone_number": "415-961-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELDEN",
        "middle_name": "H.",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D4049136",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Khaw, PHARM.D.
• Maham Khawar
• Briana Khim
• Jade D Khodar-Fisher
• Durriyah Khorakiwala, PH.D.
• Eun Hee Kim
• Jennifer Hyunjoo Kim, D.D.S.
• Kwan James Kim, CCP
• Paul Kim, MD
• Anabella Grace King

• Family Nurse Practitioner in Dublin, CA
• Providers in Dublin, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.