JERRY KIM MD INC
NPI 1093452278
Surgery - Vascular Surgery in Pomona, CA

Q: What is Jerry Kim MD Inc's NPI number?

The NPI number for Jerry Kim MD Inc is 1093452278. It was assigned to this organization in the NPPES registry on May 18, 2022.

Q: What is Jerry Kim MD Inc's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Kim MD Inc was last updated on August 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 18, 2022

350 VINTON AVE STE 202, POMONA, CA 91767(909) 973-1148(909) 363-4954 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 24, 2022, May 18, 2022 (2 updates tracked since 2022).

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About Jerry Kim Md Inc NPPES

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

JERRY KIM MD INC (NPI 1093452278) is a healthcare organization registered as a vascular surgery in Pomona, California and active in the NPI registry since May 2022. The organization lists Jerry J Kim, Owner, as its authorized official.

NPPES Registry Identity

NPI1093452278

Entity TypeOrganization

Primary Taxonomy2086S0129X

Legal Business NameJERRY KIM MD INC

Location Address350 VINTON AVE STE 202Pomona, CA 91767-3000

Mailing Address2625 Roadrunner DrLa Verne, CA 91750-2350

Phone(909) 973-1148

Fax(909) 363-4954

Organization SubpartNo

Authorized OfficialJerry J KimOwner · (818) 913-2393

Enumeration DateMay 18, 2022

Last NPPES UpdateAugust 1, 20232 updates tracked since enumeration

NPPES CertifiedAugust 1, 2023

✔ NPI 1093452278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Also ListedSurgeryTaxonomy 208600000X

350 VINTON AVE STE 202, Pomona, CA 91767

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerry Kim Md Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Jerry Kim MD Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Jerry Kim, MD

General Surgery

NPI 1912295510

350 VINTON AVE STE 202
Pomona, CA 91767

(909) 909-1148

✔ PECOS✔ Accepts MedicareSame address

Alexander Lam, MD

Vascular Surgery

NPI 1205497104

350 VINTON AVE STE 202
Pomona, CA 91767

(909) 973-1148

✔ PECOS✔ Accepts MedicareSame address

Ahmad Hussain, M.D.

Vascular Surgery

NPI 1598999823

315 N 3RD AVE STE 300
Covina, CA 91723

(626) 337-3500

✔ PECOS✔ Accepts Medicare8.4 mi

Dennis Nemceff, MD

Vascular Surgery

NPI 1427371228

2130 CITRACADO PKWY STE 300
Escondido, CA 92029

(760) 291-6650

✔ PECOS✔ Accepts Medicare75 mi

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

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 Jerry Kim MD Inc's NPI number?

The NPI number for Jerry Kim MD Inc is 1093452278. It was assigned to this organization in the NPPES registry on May 18, 2022.

Where is Jerry Kim MD Inc located?

Jerry Kim MD Inc is located at 350 Vinton Ave Ste 202, Pomona, CA 91767. The listed phone number is (909) 973-1148.

What is Jerry Kim MD Inc's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Jerry Kim MD Inc enrolled in Medicare?

Yes. Jerry Kim MD Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jerry Kim MD Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Jerry Kim MD Inc. A 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 the clinician's services. The largest specialties are Vascular Surgery (3) and General Surgery (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jerry Kim MD Inc was last updated on August 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.