JENNY MIYON KIM M.D.
NPI 1255402012
Pediatrics - Pediatric Hematology-Oncology in San Diego, CA

Q: What is Jenny Kim's NPI number?

The NPI number for Jenny Kim is 1255402012. It was assigned to this individual provider in the NPPES registry on November 13, 2006.

Q: What is Jenny Kim's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Q: When was this NPI record last updated?

The NPPES record for Jenny Kim was last updated on August 30, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since November 13, 2006PECOS Enrolled

3010 CHILDRENS WAY, 2-WEST, SAN DIEGO, CA 92123(858) 966-5811 Get Directions Write a Review

NPPES record last updated: August 30, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Jenny Miyon Kim M.d. NPPES

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

JENNY MIYON KIM M.D. (NPI 1255402012) is an individual pediatric hematology-oncology provider in San Diego, California, licensed in California (A80257) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255402012

Entity TypeIndividualFemale

Primary Taxonomy2080P0207X

Provider Legal NameJENNY MIYON KIMCredential: M.D.

Location Address3010 CHILDRENS WAY, 2-WESTSan Diego, CA 92123-4223

Mailing Address3860 Calle Fortunada, Suite 210San Diego, CA 92123-4800 · (858) 309-6303 · Fax (858) 309-6301

Phone(858) 966-5811

Sole ProprietorNo

Enumeration DateNovember 13, 2006

Last NPPES UpdateAugust 30, 2011

✔ NPI 1255402012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0207X

License✔ Licensed in CA · A80257

Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Also ListedPediatricsTaxonomy 208000000X · License A80257 (CA)

3010 CHILDRENS WAY, San Diego, CA 92123

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Other Identifiers 1

Medicaid00A802570CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenny Miyon Kim M.d. 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 Reassignment

Medicare enrollment records show Jenny Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Rady Children's Hospital San Diego

Same address

Pediatrics

3020 CHILDRENS WAY
San Diego, CA 92123

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

NPI 1669617197 (858) 966-5911

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

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.

DR. KATHERINE N. NYMAN MD

Pediatrics (Neonatal-Perinatal Medicine)