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KISUNG KIM BM
NPI 1073939815
Pediatrics - Adolescent Medicine in Red Bluff, CA

Active since March 17, 2014PECOS Enrolled
2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080(530) 527-0414(530) 527-3720 Get Directions Write a Review

NPPES record last updated: April 3, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kisung Kim Bm NPPES

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

KISUNG KIM BM (NPI 1073939815) is an individual adolescent medicine provider in Red Bluff, California, licensed in California (A141207) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073939815
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameKISUNG KIMCredential: BM
Location Address2450 SISTER MARY COLUMBA DRRed Bluff, CA 96080-4356
Mailing Address2450 Sister Mary Columba DrRed Bluff, CA 96080-4356
Phone(530) 527-0414
Fax(530) 527-3720
Sole ProprietorNo
Enumeration DateMarch 17, 2014
Last NPPES UpdateApril 3, 2019
✔ NPI 1073939815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in CA · A141207
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
2450 SISTER MARY COLUMBA DR, Red Bluff, CA 96080
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kisung Kim Bm 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 Reassignment

Medicare enrollment records show Kisung Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shasta Community Health Center
30 mi
Federally Qualified Health Center (FQHC)
1201 INDUSTRIAL ST
Redding, CA 96002
  • Reassigned Medicare billing, California enrollment
  • 144 clinicians in this Medicare group
NPI 1669004123 (530) 246-5710

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%1,282 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
27%146 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%110 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
92%1,305 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
96%1,305 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
15%1,305 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
21%1,305 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

LASSEN MEDICAL GROUP INC
Family Medicine
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0141
LEE SHOOP MD
Family Medicine
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0414
DAVID DAHNKE
Internal Medicine
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0414
MRS. KATE ASHLEY ELLIS PA-C
Physician Assistant (Medical)
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0414
MORGAN LEE SANDHAGEN PHYSICIAN ASSISTANT
Physician Assistant
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 390-3938
DR. DANIEL FERRIN LEAVITT MD
Family Medicine
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0414
INTEGRATED DERMATOLOGY OF LINCOLN, PC
Dermatology
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0414
KIMBERLI FRANTZ MD
Pediatrics
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA 96080
Tehama County (530) 527-0414

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 Kisung Kim's NPI number?

The NPI number for Kisung Kim is 1073939815. It was assigned to this individual provider in the NPPES registry on March 17, 2014.

Where is Kisung Kim located?

Kisung Kim practices at 2450 Sister Mary Columba Dr, Red Bluff, CA 96080. The listed phone number is (530) 527-0414.

What is Kisung Kim's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Kisung Kim enrolled in Medicare?

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

Which organization bills Medicare for Kisung Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kisung Kim reassigns Medicare benefits to Shasta Community Health Center (Redding, 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 Kisung 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 Kisung Kim was last updated on April 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.