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

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: August 02, 2026.

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

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
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

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

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, I20201207002894
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.

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
DME-Medical/Surgical Supplies · category DA023N
2 suppliers243 claims8,471 services$30.02 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
2 suppliers131 claims4,402 services$7.14 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing A6197
DME-Medical/Surgical Supplies · category DA023N
2 suppliers59 claims1,559 services$15.88 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches A6199
DME-Medical/Surgical Supplies · category DA023N
2 suppliers23 claims1,260 services$5.08 avg. paid by Medicare
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6203
DME-Medical/Surgical Supplies · category DA023N
2 suppliers46 claims875 services$3.24 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 13

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

Acupuncturist
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Family Medicine (Geriatric Medicine)
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Nurse Practitioner (Family)
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Clinic/Center (Rehabilitation)
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Orthopaedic Surgery (Sports Medicine)
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Acupuncturist
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780
Orthopaedic Surgery
14642 NEWPORT AVE STE 105
TUSTIN, CA 92780

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 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.

Where is Charles Chol Bae Kim located?

Charles Chol Bae Kim practices at 14642 Newport Ave Ste 105, Tustin, CA 92780. The listed phone number is (714) 831-1112.

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.

Is Charles Chol Bae Kim enrolled in Medicare?

Yes. Charles Chol Bae 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 Charles Chol Bae Kim was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.