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MR. ELIJAH SANGKU-DANIEL KIM PMHNP-BC
NPI 1225501109
Nurse Practitioner - Psychiatric/Mental Health in San Marcos, CA

Active since January 03, 2019PECOS Enrolled
277 RANCHEROS DR STE 301, SAN MARCOS, CA 92069(855) 501-1004(760) 471-4078 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 22, 2026, Jan 12, 2026, May 12, 2019 and 1 more (4 updates tracked since 2019).

About Mr. Elijah Sangku-daniel Kim Pmhnp-bc NPPES

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

MR. ELIJAH SANGKU-DANIEL KIM PMHNP-BC (NPI 1225501109) is an individual psychiatric/mental health provider in San Marcos, California, licensed in California (19455) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1225501109
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. ELIJAH SANGKU-DANIEL KIMCredential: PMHNP-BC
Location Address277 RANCHEROS DR STE 301San Marcos, CA 92069-2993
Mailing Address3835 N Freeway Blvd Ste 100Sacramento, CA 95834-1954
Phone(855) 501-1004
Fax(760) 471-4078
Sole ProprietorYes
Enumeration DateJanuary 3, 2019
Last NPPES UpdateMay 22, 20264 updates tracked since enumeration
NPPES CertifiedMay 22, 2026
✔ NPI 1225501109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 19455
277 RANCHEROS DR STE 301, San Marcos, CA 92069
Open in Google Maps ↗

Other Names 1

Other Name (5)Mr. Elijah Sangku-daniel Kim

Secondary Practice Locations 2

Location 1200 Mercy CircleOceanside, CA 92055 · Phone (415) 260-5997
Location 24655 Telescope AveCarlsbad, CA 92008-3766 · Phone (415) 260-5997

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Elijah Sangku-daniel Kim Pmhnp-bc 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 Reassignments

2

Medicare enrollment records show Elijah Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mark David Levine, MD Fresno
293 mi
Psychiatry
5100 N 6TH ST, STE 135
Fresno, CA 93710
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Mark David Levine MD Professional Corporation
  • 329 clinicians in this Medicare group
NPI 1124387097 (559) 490-2067
Richmond Area Multi-Services, Inc.
438 mi
Community/Behavioral Health
601 CLEMENT ST
San Francisco, CA 94118
  • Reassigned Medicare billing, California enrollment
  • 25 clinicians in this Medicare group
NPI 1548312309 (415) 668-5955

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 92069 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

KEVIN BARR MFT
Marriage & Family Therapist
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (604) 714-0737
MS. CYNTHIA ELIZABETH MANLY NP
Nurse Practitioner (Psychiatric/Mental Health)
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (855) 501-1004
ELOISA B DIETRICH
Nurse Practitioner (Psychiatric/Mental Health)
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (760) 471-4073
CHRISTINE HJORTNAES LMFT
Marriage & Family Therapist
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (760) 471-4073
DR. GEORGE KOUMARAS PHD
Psychologist
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (760) 471-4073
MR. ANIL S PATEL MD
Psychiatry & Neurology (Psychiatry)
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (855) 501-1004
MR. DENNIS M ORDAS MD
Psychiatry & Neurology (Psychiatry)
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (760) 714-0734
THERESA TILKER LCSW
Social Worker (Clinical)
277 RANCHEROS DR STE 301
SAN MARCOS, CA 92069
San Diego County (760) 471-4073

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 Elijah Kim's NPI number?

The NPI number for Elijah Kim is 1225501109. It was assigned to this individual provider in the NPPES registry on January 3, 2019. The provider is also known as Mr. Elijah Sangku-Daniel Kim.

Where is Elijah Kim located?

Elijah Kim practices at 277 Rancheros Dr Ste 301, San Marcos, CA 92069. The listed phone number is (855) 501-1004.

What is Elijah Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Elijah Kim enrolled in Medicare?

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

Which organizations bill Medicare for Elijah Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elijah Kim reassigns Medicare benefits to 2 organizations: Mark David Levine, MD Fresno (Fresno, CA) and Richmond Area Multi-Services, Inc. (San Francisco, CA). Each 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 Elijah 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 Elijah Kim was last updated on May 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.