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JIYEON KIM NURSE PRACTITIONER
NPI 1043780216
Nurse Practitioner in Reseda, CA

Active since November 30, 2018PECOS EnrolledAccepts Medicare Assignment
18107 SHERMAN WAY STE 200, RESEDA, CA 91335(818) 783-1002 Get Directions Write a Review

NPPES record last updated: March 31, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 10, 2021, Nov 11, 2019, Nov 30, 2018 (3 updates tracked since 2018).

About Jiyeon Kim Nurse Practitioner NPPES

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

JIYEON KIM NURSE PRACTITIONER (NPI 1043780216) is an individual nurse practitioner in Reseda, California, licensed in California (95006590) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1043780216
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameJIYEON KIMCredential: NURSE PRACTITIONER
Location Address18107 SHERMAN WAY STE 200Reseda, CA 91335-8802
Mailing Address18107 Sherman Way Ste 200Reseda, CA 91335-8802 · (818) 783-1112
Phone(818) 783-1002
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateNovember 30, 2018
Last NPPES UpdateMarch 31, 20223 updates tracked since enumeration
NPPES CertifiedMarch 31, 2022
✔ NPI 1043780216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95006590
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
18107 SHERMAN WAY STE 200, Reseda, CA 91335
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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

Jiyeon Kim Nurse Practitioner 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 ID4789924713
PECOS Enrollment IDI20190328002553
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91335 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. POY SAKJIRAPAPONG YAMADA NP
Nurse Practitioner (Family)
18107 SHERMAN WAY STE 200
RESEDA, CA 91335
Los Angeles County (818) 783-1002
RODOLFO ALVARADO PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
18107 SHERMAN WAY STE 200
RESEDA, CA 91335
Los Angeles County (818) 783-1002

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 Jiyeon Kim's NPI number?

The NPI number for Jiyeon Kim is 1043780216. It was assigned to this individual provider in the NPPES registry on November 30, 2018.

Where is Jiyeon Kim located?

Jiyeon Kim practices at 18107 Sherman Way Ste 200, Reseda, CA 91335. The listed phone number is (818) 783-1002.

What is Jiyeon Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jiyeon Kim enrolled in Medicare?

Yes. Jiyeon 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 Jiyeon Kim was last updated on March 31, 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.