TRACEY SHIN KIM MD
NPI 1003556028
Internal Medicine in Whittier, CA

Q: What is Tracey Kim's NPI number?

The NPI number for Tracey Kim is 1003556028. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Q: What is Tracey Kim's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Tracey Kim was last updated on September 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since March 29, 2022PECOS EnrolledAccepts Medicare Assignment

12401 WASHINGTON BLVD, WHITTIER, CA 90602(562) 698-0811(562) 789-5902 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Tracey Shin Kim Md NPPES

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

TRACEY SHIN KIM MD (NPI 1003556028) is an individual internal medicine provider in Whittier, California, licensed in California (A190164) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Jose, and is a graduate of Drexel University College Of Medicine (2018).

NPPES Registry Identity

NPI1003556028

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameTRACEY SHIN KIMCredential: MD

Location Address12401 WASHINGTON BLVDWhittier, CA 90602-1006

Mailing Address12401 Washington BlvdWhittier, CA 90602-1006 · (562) 698-0811

Phone(562) 698-0811

Fax(562) 789-5902

Sole ProprietorNo

Medical School CMSDrexel University College Of MedicineGraduated 2018

Enumeration DateMarch 29, 2022

Last NPPES UpdateSeptember 9, 2025

NPPES CertifiedSeptember 9, 2025

✔ NPI 1003556028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A190164

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

12401 WASHINGTON BLVD, Whittier, CA 90602

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Secondary Practice Location 1

Location 1751 S Bascom AveSan Jose, CA 95128-2604 · Phone (714) 623-8226

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

Tracey Shin Kim Md 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 ID42700601

PECOS Enrollment IDI20251103003914

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 Tracey Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pih Health Physicians

Same address

Ophthalmology

12401 WASHINGTON BLVD, SUITE 100
Whittier, CA 90602

Reassigned Medicare billing, California enrollment
840 clinicians in this Medicare group

NPI 1295131621 (562) 967-2885

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90602 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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