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MRS. KIMBERLY LEILANI EDICK R.N.
NPI 1003162579
Student in an Organized Health Care Education/Training Program in Irvine, CA

Active since August 01, 2012
6640 ALTON PKWY, IRVINE, CA 92618(949) 932-5000 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Kimberly Leilani Edick R.n. NPPES

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

MRS. KIMBERLY LEILANI EDICK R.N. (NPI 1003162579) is an individual student in an organized health care education/training program in Irvine, California, licensed in California (714375) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1003162579
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMRS. KIMBERLY LEILANI EDICKCredential: R.N.
Location Address6640 ALTON PKWYIrvine, CA 92618-3734
Mailing Address426 Molino AveLong Beach, CA 90814-1201
Phone(949) 932-5000
Sole ProprietorNo
Enumeration DateAugust 1, 2012
Last NPPES UpdateDecember 21, 2021
NPPES CertifiedDecember 21, 2021
✔ NPI 1003162579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CA · 714375
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
6640 ALTON PKWY, Irvine, CA 92618
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Other Names 1

Former Name (1)Miss Kimberly Leilani Portner R.n.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kimberly Leilani Edick R.n. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Southern California Permanente Medical Group
14 mi
Health Maintenance Organization
441 N LAKEVIEW AVE
Anaheim, CA 92807
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1952333460 (714) 279-4000

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.

MS. MARIANNA HELEN GABRIEL RD CHES
Dietitian, Registered
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (949) 932-6734
SAHAR TOFIGH
Respiratory Therapist, Certified
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (949) 932-6880
JESSICA TING LIU
Respiratory Therapist, Certified
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (949) 932-6880
ANDERSON VU
Internal Medicine
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (833) 574-2273
JEFFREY BURKHOLDER
Registered Nurse (Administrator)
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (949) 932-2863
ADAM WOOTTON ARRT(R)(MR)
Radiology (Diagnostic Radiology)
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (714) 928-7715
MS. LILLIAN JARA MORELL MSW, LCSW
Social Worker (Clinical)
6640 ALTON PKWY
IRVINE, CA 92618
Orange County (949) 932-2970
ROSA CHANG L.C.S.W.
Social Worker
6640 ALTON PKWY, 2ND FLOOR
IRVINE, CA 92618
Orange County (949) 932-6234

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 Kimberly Edick's NPI number?

The NPI number for Kimberly Edick is 1003162579. It was assigned to this individual provider in the NPPES registry on August 1, 2012. The provider is also known as Miss Kimberly Leilani Portner R.N..

Where is Kimberly Edick located?

Kimberly Edick practices at 6640 Alton Pkwy, Irvine, CA 92618. The listed phone number is (949) 932-5000.

What is Kimberly Edick's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kimberly Edick enrolled in Medicare?

Yes. Kimberly Edick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Edick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Edick reassigns Medicare benefits to Southern California Permanente Medical Group (Anaheim, 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 Kimberly Edick'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 Kimberly Edick was last updated on December 21, 2021. 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.