KATHLEEN KIM
NPI 1508213562
Family Medicine in Davis, CA
About Kathleen Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHLEEN KIM (NPI 1508213562) is an individual family medicine provider in Davis, California, licensed in California (19986) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2016).
NPPES Registry Identity
Specialties & Licenses 2
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
Kathleen Kim 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.
Medicare Billing Reassignments
2Medicare enrollment records show Kathleen Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Vacaville, CA 95687
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Northbay Physicians Surgery Center, LLC
- 516 clinicians in this Medicare group
Fairfield, CA 94534
- Reassigned Medicare billing, California enrollment
- 225 clinicians in this Medicare group
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 95616 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Kathleen Kim's NPI number?
The NPI number for Kathleen Kim is 1508213562. It was assigned to this individual provider in the NPPES registry on May 19, 2016.
Where is Kathleen Kim located?
Kathleen Kim practices at 2019 Anderson Rd Ste B, Davis, CA 95616. The listed phone number is (530) 758-5492.
What is Kathleen Kim's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kathleen Kim enrolled in Medicare?
Yes. Kathleen 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 Kathleen Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Kim reassigns Medicare benefits to 2 organizations: Northbay Healthcare Group (Vacaville, CA) and Northbay Health Medical Foundation (Fairfield, 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 Kathleen 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 Kathleen Kim was last updated on October 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Kathleen Kim · NPI 1508213562
Family Medicine physician in Davis, California. Individual provider, active in the CMS NPPES registry since May 19, 2016.
## Identity
- **NPI:** 1508213562 (Entity type: Individual)
- **Enumerated:** May 19, 2016
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 19986 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2019 ANDERSON RD STE B, Davis, CA 95616-0773
- **Phone:** (530) 758-5492
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Northbay Healthcare Group (NPI 1255483202, Vacaville, CA); Northbay Health Medical Foundation (NPI 1760283527, Fairfield, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York College Of Osteo Medicine Of New York Institute Of Technology, class of 2016
## Record status
- **NPPES last updated:** October 2, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1508213562) · Data from the CMS NPPES public registry.