GRACE KIM FNP-C
NPI 1205344967
Nurse Practitioner - Family in Cerritos, CA
About Grace Kim Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRACE KIM FNP-C (NPI 1205344967) is an individual family provider in Cerritos, California, licensed in California (95007722) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Santa Fe Springs.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grace Kim Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Grace Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cerritos, CA 90703
- Reassigned Medicare billing, California enrollment
- 235 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 90703 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
CERRITOS, CA 90703
CERRITOS, CA 90703
CERRITOS, CA 90703
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 Grace Kim's NPI number?
The NPI number for Grace Kim is 1205344967. It was assigned to this individual provider in the NPPES registry on January 16, 2018.
Where is Grace Kim located?
Grace Kim practices at 12900 Park Plaza Dr, Cerritos, CA 90703. The listed phone number is (562) 622-2800.
What is Grace Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Grace Kim enrolled in Medicare?
Yes. Grace Kim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Grace Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Grace Kim reassigns Medicare benefits to Albion Medical Partners Of California West P C (Cerritos, 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 Grace 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 Grace Kim was last updated on April 5, 2018. 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.
# Grace Kim, FNP-C · NPI 1205344967
Family physician in Cerritos, California. Individual provider, active in the CMS NPPES registry since January 16, 2018.
## Identity
- **NPI:** 1205344967 (Entity type: Individual)
- **Enumerated:** January 16, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95007722 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 12900 PARK PLAZA DR, Cerritos, CA 90703-9329
- **Phone:** (562) 622-2800
## 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:** Albion Medical Partners Of California West P C (NPI 1073110607, Cerritos, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 5, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1205344967) · Data from the CMS NPPES public registry.