MERIDIAN SPORTS MEDICINE & PAIN CLINIC
NPI 1356671861
Pain Medicine - Pain Medicine in Anaheim, CA
About Meridian Sports Medicine & Pain Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MERIDIAN SPORTS MEDICINE & PAIN CLINIC (NPI 1356671861) is a healthcare organization registered as a pain medicine in Anaheim, California and active in the NPI registry since January 2010. The organization holds a CLIA Waiver certificate valid through November 29, 2027 and lists Chin Se Kim, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Meridian Sports Medicine & Pain Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Meridian Sports Medicine & Pain Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Anaheim, CA 92801
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D2084686
Chin SE Kim M.D., Inc · Anaheim, CAFrequently 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 Chin SE Kim, MD Inc's NPI number?
The NPI number for Chin SE Kim, MD Inc is 1356671861. It was assigned to this organization in the NPPES registry on January 5, 2010. The provider is doing business as Meridian Sports Medicine & Pain Clinic.
Where is Chin SE Kim, MD Inc located?
Chin SE Kim, MD Inc is located at 1736 W Medical Center Dr Ste B, Anaheim, CA 92801. The listed phone number is (714) 520-0809.
What is Chin SE Kim, MD Inc's specialty?
The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.
Is Chin SE Kim, MD Inc enrolled in Medicare?
Yes. Chin SE Kim, MD Inc is registered in the Medicare PECOS enrollment system.
When is Chin SE Kim, MD Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Chin SE Kim, MD Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Chin SE Kim, MD Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Chin SE Kim, MD Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2084686) is associated with this NPI, valid through November 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Chin SE Kim, MD Inc was last updated on February 2, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Meridian Sports Medicine & Pain Clinic · NPI 1356671861
Pain Medicine organization in Anaheim, California. Organization record, active in the CMS NPPES registry since January 5, 2010.
## Identity
- **NPI:** 1356671861 (Entity type: Organization)
- **Enumerated:** January 5, 2010
- **Primary specialty:** Pain Medicine - Pain Medicine · taxonomy 208VP0000X
- **Legal business name:** Chin Se Kim, Md Inc
- **Organization subpart:** No
- **Authorized official:** Chin Kim, PRESIDENT
## Practice location
- **Address:** 1736 W MEDICAL CENTER DR STE B, Anaheim, CA 92801-1854
- **Phone:** (714) 520-0809 · **Fax:** (714) 520-0835
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 2, 2010
- **Other identifiers:** Medicare UPIN E48498 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1356671861) · Data from the CMS NPPES public registry.