JESSICA JAEHEE KIM PA-C
NPI 1003458977
Physician Assistant - Surgical in Montclair, CA
About Jessica Jaehee Kim Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSICA JAEHEE KIM PA-C (NPI 1003458977) is an individual surgical provider in Montclair, California, licensed in California (57333) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jessica Jaehee Kim Pa-c 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.
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 Jessica Kim's NPI number?
The NPI number for Jessica Kim is 1003458977. It was assigned to this individual provider in the NPPES registry on October 11, 2019.
Where is Jessica Kim located?
Jessica Kim practices at 4950 San Bernardino St Ste 200, Montclair, CA 91763. The listed phone number is (909) 621-7647.
What is Jessica Kim's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Jessica Kim enrolled in Medicare?
Yes. Jessica 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.
When was this NPI record last updated?
The NPPES record for Jessica Kim was last updated on June 29, 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.
# Jessica Jaehee Kim, PA-C · NPI 1003458977
Surgical physician in Montclair, California. Individual provider, active in the CMS NPPES registry since October 11, 2019.
## Identity
- **NPI:** 1003458977 (Entity type: Individual)
- **Enumerated:** October 11, 2019
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** 57333 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4950 SAN BERNARDINO ST STE 200, Montclair, CA 91763-2328
- **Phone:** (909) 621-7647
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** June 29, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1003458977) · Data from the CMS NPPES public registry.