1. Home
  2. Directory
  3. California
  4. Sacramento
  5. Family Medicine
  6. NPI Profile

LISA KIM
NPI 1124761226
Family Medicine in Sacramento, CA

Active since April 16, 2022PECOS EnrolledAccepts Medicare Assignment
501 J ST, SACRAMENTO, CA 95814(916) 497-3000 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Apr 16, 2022 (2 updates tracked since 2022).

About Lisa Kim NPPES

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

LISA KIM (NPI 1124761226) is an individual family medicine provider in Sacramento, California, licensed in California (A189168) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of State University Of New York Downstate Medical Center (2022).

NPPES Registry Identity

NPI1124761226
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameLISA KIM
Location Address501 J STSacramento, CA 95814-2325
Mailing Address501 J StSacramento, CA 95814-2325
Phone(916) 497-3000
Sole ProprietorYes
Medical School CMSState University Of New York Downstate Medical CenterGraduated 2022
Enumeration DateApril 16, 2022
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2025
✔ NPI 1124761226 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A189168
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
501 J ST, Sacramento, CA 95814
Open in Google Maps ↗

Other Names 1

Other Name (5)Ezra Kim

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa 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.

PECOS PAC ID7719486703
PECOS Enrollment IDI20260323002798
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95814 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

RENU BANSAL MD
Student in an Organized Health Care Education/Training Program
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3000
BRYAN RANGEL-ALVAREZ MD
Student in an Organized Health Care Education/Training Program
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3000
DR. NEHA MANNIKAR MD
Student in an Organized Health Care Education/Training Program
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3019
PRITHA GHOSH ROY MD
Student in an Organized Health Care Education/Training Program
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3019
MIKAEL R HABTEZION PHARMD
Pharmacist (Ambulatory Care)
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3000
TRIPAT CHEEMA
Pharmacist
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3000
JENNIFER NG
Student in an Organized Health Care Education/Training Program
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 497-3000
LIANA STEFAN LIANOV MD MPH
Internal Medicine
501 J ST
SACRAMENTO, CA 95814
Sacramento County (916) 765-5116

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 Lisa Kim's NPI number?

The NPI number for Lisa Kim is 1124761226. It was assigned to this individual provider in the NPPES registry on April 16, 2022. The provider is also known as Ezra Kim.

Where is Lisa Kim located?

Lisa Kim practices at 501 J St, Sacramento, CA 95814. The listed phone number is (916) 497-3000.

What is Lisa Kim's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lisa Kim enrolled in Medicare?

Yes. Lisa 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.

When was this NPI record last updated?

The NPPES record for Lisa Kim was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.