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HAENA KIM MD
NPI 1275799124
Otolaryngology - Facial Plastic Surgery in San Jose, CA

Active since July 31, 2008PECOS EnrolledAccepts Medicare Assignment
455 OCONNOR DR STE 280, SAN JOSE, CA 95128(650) 507-3601(650) 396-7922 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 13, 2025, Aug 9, 2023 (2 updates tracked since 2023).

About Haena Kim Md NPPES

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

HAENA KIM MD (NPI 1275799124) is an individual facial plastic surgery provider in San Jose, California, licensed in California (A126331) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1275799124
Entity TypeIndividualFemale
Primary Taxonomy207YS0123X
Provider Legal NameHAENA KIMCredential: MD
Location Address455 OCONNOR DR STE 280San Jose, CA 95128-1644
Mailing Address455 Oconnor Dr Ste 280San Jose, CA 95128-1644 · (650) 507-3601 · Fax (650) 396-7922
Phone(650) 507-3601
Fax(650) 396-7922
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateJuly 31, 2008
Last NPPES UpdateAugust 25, 20252 updates tracked since enumeration
NPPES CertifiedAugust 22, 2025
✔ NPI 1275799124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YS0123X
License✔ Licensed in CA · A126331
Definition
An otolaryngologist who specializes in facial plastic surgery.
Also ListedOtolaryngology · Otolaryngology/Facial Plastic SurgeryTaxonomy 207YX0905X · License MD207073 (OR)
455 OCONNOR DR STE 280, San Jose, CA 95128
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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

Haena 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 ID7113182460
PECOS Enrollment IDI20130807000150
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

3

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

Permanente Medical Group Inc
3.2 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000
John Muir Trauma Physicians Billing Service
41 mi
Hospitalist
1601 YGNACIO VALLEY RD
Walnut Creek, CA 94598
  • Reassigned Medicare billing, California enrollment
  • 810 clinicians in this Medicare group
NPI 1093864837 (925) 947-5331
Eastmoreland Ear, Nose & Throat, Clinic, LLP
561 mi
Otolaryngology/Facial Plastic Surgery
10151 SE SUNNYSIDE RD STE 240
Clackamas, OR 97015
  • Reassigned Medicare billing, Oregon enrollment
  • 15 clinicians in this Medicare group
NPI 1386754398 (503) 233-5548

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 2

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
17 services14 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
12 services12 patients

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 Haena Kim's NPI number?

The NPI number for Haena Kim is 1275799124. It was assigned to this individual provider in the NPPES registry on July 31, 2008.

Where is Haena Kim located?

Haena Kim practices at 455 Oconnor Dr Ste 280, San Jose, CA 95128. The listed phone number is (650) 507-3601.

What is Haena Kim's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

Is Haena Kim enrolled in Medicare?

Yes. Haena 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.

Which organizations bill Medicare for Haena Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Haena Kim reassigns Medicare benefits to 3 organizations: Permanente Medical Group Inc (Santa Clara, CA), John Muir Trauma Physicians Billing Service (Walnut Creek, CA) and Eastmoreland Ear, Nose & Throat, Clinic, LLP (Clackamas, OR). 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 Haena Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Haena Kim accept?

Health plans from Moda Health Plan, Inc. list Haena Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Haena Kim was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.