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GRACE CHARMIE KIM MD, MPP
NPI 1013479997
Pediatrics in Mammoth Lakes, CA

Active since April 01, 2019PECOS Enrolled
85 SIERRA PARK RD # A, MAMMOTH LAKES, CA 93546(760) 924-4000 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 16, 2025, Jul 7, 2023, Jul 11, 2022 and 1 more (4 updates tracked since 2019).

About Grace Charmie Kim Md, Mpp NPPES

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

GRACE CHARMIE KIM MD, MPP (NPI 1013479997) is an individual pediatrics provider in Mammoth Lakes, California, licensed in California (A178510) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Bishop.

NPPES Registry Identity

NPI1013479997
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameGRACE CHARMIE KIMCredential: MD, MPP
Location Address85 SIERRA PARK RD # AMammoth Lakes, CA 93546-2073
Mailing Address85 Sierra Park RdMammoth Lakes, CA 93546-2073
Phone(760) 924-4000
Sole ProprietorNo
Enumeration DateApril 1, 2019
Last NPPES UpdateJune 16, 20254 updates tracked since enumeration
NPPES CertifiedJune 16, 2025
✔ NPI 1013479997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A178510
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
85 SIERRA PARK RD # A, Mammoth Lakes, CA 93546
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Secondary Practice Location 1

Location 1152 Pioneer Ln Ste HBishop, CA 93514-2563 · Phone (760) 873-6373 · Fax (760) 873-3266

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace Charmie Kim Md, Mpp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

3

Medicare enrollment records show Grace Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern Mono Health Care District
Same address
Critical Access Hospital
85 SIERRA PARK RD
Mammoth Lakes, CA 93546
  • Reassigned Medicare billing, California enrollment
  • 83 clinicians in this Medicare group
NPI 1962444059 (760) 934-3311
Northern Inyo Associates
36 mi
Clinic/Center
152 PIONEER LN, SUITE D
Bishop, CA 93514
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Northern Inyo Healthcare District
  • Also billed through NPI 1922198712 (California)
  • 131 clinicians in this Medicare group
NPI 1649664848 (760) 872-1606
Southern California Permanente Medical Group
210 mi
Health Maintenance Organization
43112 N 15TH ST
Lancaster, CA 93534
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1982863783 (661) 726-2279

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 93546 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

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 Grace Kim's NPI number?

The NPI number for Grace Kim is 1013479997. It was assigned to this individual provider in the NPPES registry on April 1, 2019.

Where is Grace Kim located?

Grace Kim practices at 85 Sierra Park Rd # A, Mammoth Lakes, CA 93546. The listed phone number is (760) 924-4000.

What is Grace Kim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Grace Kim enrolled in Medicare?

Yes. Grace Kim is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Grace Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Grace Kim reassigns Medicare benefits to 3 organizations: Southern Mono Health Care District (Mammoth Lakes, CA), Northern Inyo Associates (Bishop, CA) and Southern California Permanente Medical Group (Lancaster, CA). Each 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 Grace 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 Grace Kim was last updated on June 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.