JAE YOON KIM
NPI 1013595107
Podiatrist - Foot & Ankle Surgery in South San Francisco, CA
About Jae Yoon Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAE YOON KIM (NPI 1013595107) is an individual foot & ankle surgery provider in South San Francisco, California, licensed in Ohio (36.004128) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and is a graduate of California School Of Podiatric Medicine (2021).
NPPES Registry Identity
Specialties & Licenses 4
Accepted Insurance
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
Jae Yoon Kim 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.
Medicare Billing Reassignment
Medicare enrollment records show Jae Yoon Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Francisco, CA 94116
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
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.
SOUTH SAN FRANCISCO, CA 94080
SOUTH SAN FRANCISCO, CA 94080
SOUTH SAN FRANCISCO, CA 94080
SOUTH SAN FRANCISCO, CA 94080
SOUTH SAN FRANCISCO, CA 94080
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 Jae Yoon Kim's NPI number?
The NPI number for Jae Yoon Kim is 1013595107. It was assigned to this individual provider in the NPPES registry on March 30, 2021.
Where is Jae Yoon Kim located?
Jae Yoon Kim practices at 1200 El Camino Real, South San Francisco, CA 94080. The listed phone number is (650) 742-2000.
What is Jae Yoon Kim's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Jae Yoon Kim enrolled in Medicare?
Yes. Jae Yoon 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 Jae Yoon Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jae Yoon Kim reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, 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 Jae Yoon Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jae Yoon Kim accept?
Health plans from Antidote Health Plan of Ohio, Inc. and CareSource list Jae Yoon Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jae Yoon Kim was last updated on September 30, 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.
# Jae Yoon Kim · NPI 1013595107
Foot & Ankle Surgery provider in South San Francisco, California. Individual provider, active in the CMS NPPES registry since March 30, 2021.
## Identity
- **NPI:** 1013595107 (Entity type: Individual)
- **Enumerated:** March 30, 2021
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** 36.004128 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1200 EL CAMINO REAL, South San Francisco, CA 94080-3299
- **Phone:** (650) 742-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1841373800, San Francisco, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** California School Of Podiatric Medicine, class of 2021
## Record status
- **NPPES last updated:** September 30, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1013595107) · Data from the CMS NPPES public registry.