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DR. CHOLL WAN KIM M.D., PH.D
NPI 1124043765
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in San Diego, CA

Active since July 13, 2006Opted out of Medicare · through May 1, 2027
3.73/100
CMS Quality Rating
6719 ALVARADO RD STE 304, SAN DIEGO, CA 92120(619) 344-6918(619) 333-6029 Get Directions Write a Review

NPPES record last updated: December 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 12, 2022, Mar 9, 2022 (2 updates tracked since 2022).

About Dr. Choll Wan Kim M.d., Ph.d NPPES

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

DR. CHOLL WAN KIM M.D., PH.D (NPI 1124043765) is an individual orthopaedic surgery of the spine provider in San Diego, California, licensed in California (A64323) and active in the NPI registry since July 2006. He has opted out of Medicare through May 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124043765
Entity TypeIndividualMale
Primary Taxonomy207XS0117X
Provider Legal NameDR. CHOLL WAN KIMCredential: M.D., PH.D
Location Address6719 ALVARADO RD STE 304San Diego, CA 92120-5265
Mailing Address6719 Alvarado Rd Ste 304San Diego, CA 92120-5265 · (619) 344-6918 · Fax (619) 333-6029
Phone(619) 344-6918
Fax(619) 333-6029
Sole ProprietorNo
Enumeration DateJuly 13, 2006
Last NPPES UpdateDecember 12, 20222 updates tracked since enumeration
NPPES CertifiedDecember 12, 2022
✔ NPI 1124043765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic Surgery of the SpineAllopathic & Osteopathic Physicians
Taxonomy Code207XS0117X
License✔ Licensed in CA · A64323
Definition
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License A64323 (CA)
6719 ALVARADO RD STE 304, San Diego, CA 92120
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Other Identifiers 1

Medicaid00A643230CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Choll Wan Kim M.d., Ph.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 1, 2023 through May 1, 2027.

Opt-Out Effective DateMay 1, 2023
Opt-Out In Effect ThroughMay 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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.

3.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost12.45

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Osteogenesis stimulator, electrical, non-invasive, spinal applications E0748
DME-Other DME · category DE000N
2 suppliers16 claims16 services$3,751.77 avg. paid by Medicare
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0650
DME-Orthotic Devices · category DF007N
1 supplier30 claims30 services$311.95 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

DANIELLE FRANCES MORGEN PA-C
Physician Assistant
6719 ALVARADO RD STE 304
SAN DIEGO, CA 92120
San Diego County (619) 344-6918
KENDRA ROBERTA WITT
Physician Assistant
6719 ALVARADO RD STE 304
SAN DIEGO, CA 92120
San Diego County (619) 344-6918
ALEXANDRA MARIE-MERO MCCANN
Physician Assistant
6719 ALVARADO RD STE 304
SAN DIEGO, CA 92120
San Diego County (619) 344-6918
EXCEL SPINE CENTER A CALIFORNIA MEDICAL CORPORATION
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
6719 ALVARADO RD STE 304
SAN DIEGO, CA 92120
San Diego County (619) 344-6918

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 Choll Kim's NPI number?

The NPI number for Choll Kim is 1124043765. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Choll Kim located?

Choll Kim practices at 6719 Alvarado Rd Ste 304, San Diego, CA 92120. The listed phone number is (619) 344-6918.

What is Choll Kim's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Is Choll Kim enrolled in Medicare?

No. Choll Kim has opted out of Medicare through May 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Choll Kim was last updated on December 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.