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CHARLES KIM D.O.
NPI 1003077769
Anesthesiology in Lubbock, TX

Active since June 24, 2008PECOS EnrolledAccepts Medicare Assignment
3601 4TH ST, LUBBOCK, TX 79430(806) 743-3004 Get Directions Write a Review

NPPES record last updated: January 20, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Charles Kim D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES KIM D.O. (NPI 1003077769) is an individual anesthesiology provider in Lubbock, Texas, licensed in North Dakota (12344) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1003077769
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameCHARLES KIMCredential: D.O.
Location Address3601 4TH STLubbock, TX 79430-0002
Mailing Address906 Milwaukee Ave Apt 609Lubbock, TX 79416-5965 · (305) 984-4186
Phone(806) 743-3004
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateJune 24, 2008
Last NPPES UpdateJanuary 20, 2022
NPPES CertifiedJanuary 20, 2022
✔ NPI 1003077769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in ND · 12344
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License BP10032227 (TX)
3601 4TH ST, Lubbock, TX 79430
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Charles Kim D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476705872
PECOS Enrollment IDI20121211000437
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Charles Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
1,129 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES STEVEN DEMBOWSKI PHD
Speech-Language Pathologist
3601 4TH ST, STE. 2A300
LUBBOCK, TX 79430
Lubbock County (806) 743-5678
BAILEY WADDINGTON MD
Student in an Organized Health Care Education/Training Program
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-6840
SARA SYED AHMED MD
Psychiatry & Neurology (Psychiatry)
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-2800
DR. SAFAA S. LABIB M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3601 4TH ST, SUITE 1A115
LUBBOCK, TX 79430
Lubbock County (806) 743-2155
MATTHEW PAUL FERGUSON M.D.
Orthopaedic Surgery (Sports Medicine)
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-2475
KORY NOEL HOWELL DO
Student in an Organized Health Care Education/Training Program
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3381
JANICE STACHOWIAK M.D.
Internal Medicine
3601 4TH ST
LUBBOCK, TX 79430
Lubbock County (806) 743-3150
ROBERT L. GEE LPC
Psychiatry & Neurology (Psychiatry)
3601 4TH ST, SUITE 1C102
LUBBOCK, TX 79430
Lubbock County (806) 743-2800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Kim's NPI number?

The NPI number for Charles Kim is 1003077769. It was assigned to this individual provider in the NPPES registry on June 24, 2008.

Where is Charles Kim located?

Charles Kim practices at 3601 4th St, Lubbock, TX 79430. The listed phone number is (806) 743-3004.

What is Charles Kim's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Charles Kim enrolled in Medicare?

Yes. Charles Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Charles Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Kim reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charles Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Charles Kim was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.