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DAVID KIM AGACNP-BC
NPI 1447967682
Nurse Practitioner - Acute Care in Lake Balboa, CA

Active since October 27, 2022PECOS EnrolledAccepts Medicare Assignment
16723 VANOWEN ST, LAKE BALBOA, CA 91406(818) 279-1745 Get Directions Write a Review

NPPES record last updated: December 30, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 30, 2024, Jul 25, 2024, Oct 27, 2022 (3 updates tracked since 2022).

About David Kim Agacnp-bc NPPES

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

DAVID KIM AGACNP-BC (NPI 1447967682) is an individual acute care provider in Lake Balboa, California, licensed in California (95021554) and active in the NPI registry since October 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1447967682
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameDAVID KIMCredential: AGACNP-BC
Location Address16723 VANOWEN STLake Balboa, CA 91406-4638
Mailing Address16723 Vanowen StLake Balboa, CA 91406-4638 · (818) 279-1745
Phone(818) 279-1745
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 27, 2022
Last NPPES UpdateDecember 30, 20243 updates tracked since enumeration
NPPES CertifiedJuly 25, 2024
✔ NPI 1447967682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in CA · 95021554
16723 VANOWEN ST, Lake Balboa, CA 91406
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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

David Kim Agacnp-bc 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 ID42678740
PECOS Enrollment IDI20230627002360
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 David Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group
2.7 mi
Health Maintenance Organization
8999 BALBOA BLVD
Northridge, CA 91325
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1013409036 (877) 608-0044
Mend Health Inc
4.9 mi
Urgent Care
4312 WOODMAN AVE, SUITE 102
Sherman Oaks, CA 91423
  • Reassigned Medicare billing, California enrollment
  • 37 clinicians in this Medicare group
NPI 1467849745 (310) 488-2830
Eastern Ventura Medical Group, Inc.
14 mi
Family Medicine
1980 SEQUOIA AVE
Simi Valley, CA 93063
  • Reassigned Medicare billing, California enrollment
  • 4 clinicians in this Medicare group
NPI 1417900788 (805) 583-5555

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91406 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.

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 David Kim's NPI number?

The NPI number for David Kim is 1447967682. It was assigned to this individual provider in the NPPES registry on October 27, 2022.

Where is David Kim located?

David Kim practices at 16723 Vanowen St, Lake Balboa, CA 91406. The listed phone number is (818) 279-1745.

What is David Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is David Kim enrolled in Medicare?

Yes. David 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 David Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Kim reassigns Medicare benefits to 3 organizations: Southern California Permanente Medical Group (Northridge, CA), Mend Health Inc (Sherman Oaks, CA) and Eastern Ventura Medical Group, Inc. (Simi Valley, CA). 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 David Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for David Kim was last updated on December 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.