NPIMap

Individual provider Active NPI

Andrew Heejoon Kim, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1952553380
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A126764 Issued in CA
Practice address
1414 S Grand Ave Ste 303
Los Angeles, CA 90015-3071
Phone
(213) 483-5940
NPI assigned
Oct 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A126764 CA
Hospitalist Physician 208M00000X 237795 MA
Internal Medicine Physician 207R00000X A126764 CA Primary

Addresses

Primary practice location

1414 S Grand Ave Ste 303
Los Angeles, CA 90015-3071

Mailing address

1414 S Grand Ave Ste 303
Los Angeles, CA 90015-3071

Other identifiers 2

IdentifierTypeStateIssuer
A126764OtherCACALIFORNIA
237795OtherMALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131022002364 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 5597826503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Boston University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ho S Bae M D IncGroup PAC ID 3577610229, 4 clinicians

Practice addresses (Care Compare)

520 S Virgil Ave
Suite 202
Los Angeles, CA 90020-1425
Phone (213) 368-0360

Hospital & facility affiliations

  • Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy71
Upper gastrointestinal (GI) endoscopy for acid reflux105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A126764CAMDGastroenterology Physician
237795MAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ho S Bae M D Inc Gastroenterology CurrentSince Dec 1, 2016 Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Dignity Community Care Past Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Aeger Inpatient Services Internal Medicine Past Accepting new patients
Lexica Inpatient Services Internal Medicine Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

520 S Virgil Ave
Ste 202
Los Angeles, CA 90020
Phone (213) 368-0360

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1952553380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153071",
            "telephone_number": "213-483-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "middle_name": "HEEJOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A126764",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "237795",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA",
            "identifier": "A126764",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "237795",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.