DR. KI-YOON KIM M.D.
NPI 1558715110
Internal Medicine - Gastroenterology in San Diego, CA

Active since April 20, 2016PECOS EnrolledAccepts Medicare Assignment
84.47/100
CMS Quality Rating
4060 FOURTH AVENUE, SUITE 240, SAN DIEGO, CA 92103(619) 291-6064 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 11, 2025, Oct 13, 2022 (2 updates tracked since 2022).

About Dr. Ki-yoon Kim M.d. NPPES

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

DR. KI-YOON KIM M.D. (NPI 1558715110) is an individual gastroenterology provider in San Diego, California, licensed in California (A151164) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of Rutgers New Jersey Medical School (2016).

NPPES Registry Identity

NPI1558715110
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. KI-YOON KIMCredential: M.D.
Location Address4060 FOURTH AVENUE, SUITE 240San Diego, CA 92103
Mailing Address4060 Fourth Ave Ste 240San Diego, CA 92103-2120 · (619) 291-6064
Sole ProprietorYes
Medical School CMSRutgers New Jersey Medical SchoolGraduated 2016
Enumeration DateApril 20, 2016
Last NPPES UpdateJuly 11, 20252 updates tracked since enumeration
NPPES CertifiedJuly 11, 2025
NPI 1558715110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses Licensed in CA · A151164 Licensed in NY · 315245
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
4060 FOURTH AVENUE, SUITE 240, San Diego, CA 92103

Other Identifiers 1

MedicaidKK3232267556CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Ki-yoon Kim M.d. 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 ID9234516626
PECOS Enrollment IDI20241115000391
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.

Areas of Expertise CMS Part B claims 13

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 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.
105 services77 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
40 services39 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
28 services21 patients
Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth 43237
This procedure involves a flexible tube with a camera and ultrasound device, inserted through the mouth to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like inflammation, tumors, or other abnormalities.
23 services22 patients
Review by radiologist of image from tube placement into bile duct using an endoscope 74328
This procedure involves a specialist, called a radiologist, examining an image taken during a tube placement into your bile duct. The tube is inserted with the help of a tool called an endoscope. This allows the doctor to check for any issues or abnormalities in your bile duct.
16 services14 patients
Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264
This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.
15 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 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
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.33
Promoting Interoperability100
Improvement Activities40
Cost54.91

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 Ki-yoon Kim's NPI number?

The NPI number for Ki-yoon Kim is 1558715110. It was assigned to this individual provider in the NPPES registry on April 20, 2016.

Where is Ki-yoon Kim located?

Ki-yoon Kim practices at 4060 Fourth Avenue, Suite 240, San Diego, CA 92103. The listed phone number is (619) 291-6064.

What is Ki-yoon Kim's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Ki-yoon Kim enrolled in Medicare?

Yes. Ki-yoon 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.

When was this NPI record last updated?

The NPPES record for Ki-yoon Kim was last updated on July 11, 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.