JOHN KIM M.D.
NPI 1063484392
Pediatrics in Fresno, CA
About John Kim M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN KIM M.D. (NPI 1063484392) is an individual pediatrics provider in Fresno, California, licensed in California (G74910) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.
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 (PECOS)
John Kim M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show John Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fresno, CA 93711
- Reassigned Medicare billing, California enrollment
- 508 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 93730 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 John Kim's NPI number?
The NPI number for John Kim is 1063484392. It was assigned to this individual provider in the NPPES registry on February 2, 2006.
Where is John Kim located?
John Kim practices at 1593 E Golden Valley Way Ste 104, Fresno, CA 93730. The listed phone number is (559) 434-4052.
What is John Kim's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is John Kim enrolled in Medicare?
Yes. John Kim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for John Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Kim reassigns Medicare benefits to Community Foundation Medical Group (Fresno, 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 John 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 John Kim was last updated on November 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# John Kim, M.D. · NPI 1063484392
Pediatrics physician in Fresno, California. Individual provider, active in the CMS NPPES registry since February 2, 2006.
## Identity
- **NPI:** 1063484392 (Entity type: Individual)
- **Enumerated:** February 2, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** G74910 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1593 E GOLDEN VALLEY WAY STE 104, Fresno, CA 93730-3587
- **Phone:** (559) 434-4052
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Community Foundation Medical Group (NPI 1003329491, Fresno, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 7, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1063484392) · Data from the CMS NPPES public registry.