CHARLES CHOL BAE KIM MD
NPI 1225564818
Family Medicine - Adult Medicine in Tustin, CA

Q: What is Charles Chol Bae Kim's NPI number?

The NPI number for Charles Chol Bae Kim is 1225564818. It was assigned to this individual provider in the NPPES registry on May 3, 2017.

Q: What is Charles Chol Bae Kim's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Active since May 03, 2017PECOS EnrolledAccepts Medicare Assignment

14642 NEWPORT AVE STE 105, TUSTIN, CA 92780(714) 831-1112(714) 486-2309 Get Directions Write a Review

NPPES record last updated: October 13, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 13, 2021, Mar 17, 2020, May 4, 2018 (3 updates tracked since 2018).

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About Charles Chol Bae Kim Md NPPES

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

CHARLES CHOL BAE KIM MD (NPI 1225564818) is an individual adult medicine provider in Tustin, California, licensed in California (C129160) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS and is a graduate of Other (1981).

NPPES Registry Identity

NPI1225564818

Entity TypeIndividualMale

Primary Taxonomy207QA0505X

Provider Legal NameCHARLES CHOL BAE KIMCredential: MD

Location Address14642 NEWPORT AVE STE 105Tustin, CA 92780-6058

Mailing Address1200 W Mohave RdParker, AZ 85344-6349 · (928) 669-7380

Phone(714) 831-1112

Fax(714) 486-2309

Sole ProprietorYes

Medical School CMSOtherGraduated 1981

Enumeration DateMay 3, 2017

Last NPPES UpdateOctober 13, 20213 updates tracked since enumeration

NPPES CertifiedOctober 13, 2021

✔ NPI 1225564818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0505X

License✔ Licensed in CA · C129160

Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 54481 (AZ)

Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License C-129160 (CA)

14642 NEWPORT AVE STE 105, Tustin, CA 92780

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Charles Chol Bae Kim Md 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 ID8921374232

PECOS Enrollment IDI20171031002424

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

Medicare enrollment records show Charles Chol Bae Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wound Masters Medical Group Inc

26 mi

Surgery

1131 W 6TH ST STE 250
Ontario, CA 91762

Reassigned Medicare billing, Arizona enrollment

NPI 1376063461 (833) 362-7837

Humane Medical Group

35 mi

Internal Medicine

3030 W OLYMPIC BLVD STE 220
Los Angeles, CA 90006

Reassigned Medicare billing, California enrollment
2 clinicians in this Medicare group

NPI 1164251633 (213) 446-3046

Integrated Rehab Consultants California Inc

38 mi

Physical Medicine & Rehabilitation

7716 W MANCHESTER AVE
Playa Del Rey, CA 90293

Reassigned Medicare billing, Arizona enrollment
Medicare enrollment name: La Paz Regional Hospital Inc
113 clinicians in this Medicare group

NPI 1023449741 (224) 777-8034

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

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using ultrasound 97610

Ultrasound therapy is a treatment used to heal and relieve pain. It involves using sound waves to stimulate body tissues, promoting healing and reducing inflammation. It's non-invasive, painless, and typically used for muscle, ligament injuries, or chronic pain.

1,506 services181 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

54 services22 patients

Removal of muscle and/or tissue, 20.0 sq cm or less 11043

This procedure involves the surgical removal of a specified area (20.0 sq cm or less) of muscle and/or tissue. It's typically done to treat conditions like tumors, infections, or injuries. Local or general anesthesia ensures comfort. Recovery time varies.

28 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92780 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

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.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

65%240 patients1/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

76%38 patients1/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

45%132 patients2/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

29%132 patients2/55-star benchmark: 100%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

5%132 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 16

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

Tape, waterproof, per 18 square inches A4452

DME-Medical/Surgical Supplies · category DA000N

1 supplier34 claims4,656 services$0.37 avg. paid by Medicare

Collagen based wound filler, dry form, sterile, per gram of collagen A6010