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TAEHO KIM PA
NPI 1245751775
Physician Assistant in Walnut Creek, CA

Active since July 06, 2017PECOS EnrolledAccepts Medicare Assignment
76.5/100
CMS Quality Rating
1808 SAN MIGUEL DR, WALNUT CREEK, CA 94596(925) 528-2663 Get Directions Write a Review

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2025, Oct 30, 2023, May 2, 2023 and 1 more (4 updates tracked since 2017).

About Taeho Kim Pa NPPES

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

TAEHO KIM PA (NPI 1245751775) is an individual physician assistant in Walnut Creek, California, licensed in California (54634) and active in the NPI registry since July 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1245751775
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameTAEHO KIMCredential: PA
Location Address1808 SAN MIGUEL DRWalnut Creek, CA 94596-8606
Mailing Address1808 San Miguel DrWalnut Creek, CA 94596-8606
Phone(925) 528-2663
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 6, 2017
Last NPPES UpdateFebruary 11, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2025
✔ NPI 1245751775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 54634
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1808 SAN MIGUEL DR, Walnut Creek, CA 94596
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Other Names 1

Other Name (5)Tae Kim Pa

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

Taeho Kim Pa 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 ID7113297854
PECOS Enrollment IDI20170727003523
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 94596 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
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.

76.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.31
Promoting Interoperability100
Improvement Activities40
Cost43.95

Other Providers at the Same Location NPPES 6

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

MR. MICHAEL L. POTTER M.S., M.F.T.
Marriage & Family Therapist
1808 SAN MIGUEL DR
WALNUT CREEK, CA 94596
Contra Costa County (925) 363-5855
HATICE POROY L.AC, M.D
Acupuncturist
1808 SAN MIGUEL DR
WALNUT CREEK, CA 94596
Contra Costa County (510) 333-3142
IRINA V KOLOMEY D O
Internal Medicine
1808 SAN MIGUEL DR
WALNUT CREEK, CA 94596
Contra Costa County (925) 528-2663
PARAMOUNT PAIN SOLUTIONS PC
Anesthesiology (Pain Medicine)
1808 SAN MIGUEL DR
WALNUT CREEK, CA 94596
Contra Costa County (650) 560-7400
MS. KATHY ANN AMIRI MFT
Marriage & Family Therapist
1808 SAN MIGUEL DR
WALNUT CREEK, CA 94596
Contra Costa County (925) 890-9778
BENJAMIN T. BUSFIELD MD
Orthopaedic Surgery (Sports Medicine)
1808 SAN MIGUEL DR
WALNUT CREEK, CA 94596
Contra Costa County (925) 528-2663

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 Taeho Kim's NPI number?

The NPI number for Taeho Kim is 1245751775. It was assigned to this individual provider in the NPPES registry on July 6, 2017. The provider is also known as Tae Kim PA.

Where is Taeho Kim located?

Taeho Kim practices at 1808 San Miguel Dr, Walnut Creek, CA 94596. The listed phone number is (925) 528-2663.

What is Taeho Kim's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Taeho Kim enrolled in Medicare?

Yes. Taeho 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 Taeho Kim was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.