PRISCA KIM
NPI 1063233641
Nurse Practitioner - Family in San Bernardino, CA
About Prisca Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRISCA KIM (NPI 1063233641) is an individual family provider in San Bernardino, California, licensed in California (95031605) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
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
Prisca 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 Reassignments
2Medicare enrollment records show Prisca Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Bernardino, CA 92408
- Reassigned Medicare billing, California enrollment
- 2,584 clinicians in this Medicare group
Corona, CA 92883
- Reassigned Medicare billing, California enrollment
- 12 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92408 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
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 Prisca Kim's NPI number?
The NPI number for Prisca Kim is 1063233641. It was assigned to this individual provider in the NPPES registry on October 17, 2024.
Where is Prisca Kim located?
Prisca Kim practices at 375 W Hospitality Ln, San Bernardino, CA 92408. The listed phone number is (909) 888-9977.
What is Prisca Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Prisca Kim enrolled in Medicare?
Yes. Prisca 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 organizations bill Medicare for Prisca Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Prisca Kim reassigns Medicare benefits to 2 organizations: Faculty Physicians And Surgeons Of Llusm (San Bernardino, CA) and Dalia Dawoud MD Inc (Corona, 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 Prisca 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 Prisca Kim was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Prisca Kim · NPI 1063233641
Family physician in San Bernardino, California. Individual provider, active in the CMS NPPES registry since October 17, 2024.
## Identity
- **NPI:** 1063233641 (Entity type: Individual)
- **Enumerated:** October 17, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95031605 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 375 W HOSPITALITY LN, San Bernardino, CA 92408-3203
- **Phone:** (909) 888-9977
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Faculty Physicians And Surgeons Of Llusm (NPI 1386162949, San Bernardino, CA); Dalia Dawoud MD Inc (NPI 1669228193, Corona, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** October 17, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1063233641) · Data from the CMS NPPES public registry.