Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Q: 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.

Q: What is Ki-yoon Kim's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ki-yoon Kim was last updated on October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.

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: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 2, 2026, Jul 11, 2025, Oct 13, 2022 (3 updates tracked since 2022).

On this page

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

Phone(619) 291-6064

Sole ProprietorYes

Medical School CMSRutgers New Jersey Medical SchoolGraduated 2016

Enumeration DateApril 20, 2016

Last NPPES UpdateOctober 2, 20263 updates tracked since enumeration

NPPES CertifiedOctober 2, 2026

✔ 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

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Other Identifiers 1

MedicaidKK3232267556CA

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

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.

Medicare Billing Reassignments

Medicare enrollment records show Ki-yoon Kim reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

San Diego Gastroenterology Medical Associates

Same address

Gastroenterology

4060 4TH AVE, SUITE 240
San Diego, CA 92103

Reassigned Medicare billing, California enrollment
11 clinicians in this Medicare group

NPI 1578621199 (619) 291-6064

Family Health Centers Of San Diego, Inc.

Same address

Federally Qualified Health Center (FQHC)

4065 3RD AVE
San Diego, CA 92103

Reassigned Medicare billing, California enrollment
1,100 clinicians in this Medicare group

NPI 1669827598 (619) 515-2545

On Call Specialists Medical Group Of San Diego, Inc.

0.1 mi

Specialist

4077 FIFTH AVE
San Diego, CA 92103

Reassigned Medicare billing, California enrollment
218 clinicians in this Medicare group

NPI 1962175836 (619) 294-8111

Chest And Critical Care Consultants

78 mi

Sleep Disorder Diagnostic

13522 NEWPORT AVE, SUITE 102
Tustin, CA 92780

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Chest And Critical Care Consultants A Medical Group
96 clinicians in this Medicare group

NPI 1659450054 (714) 491-1159

Kyk Medical Professional Corporation

78 mi

Gastroenterology

13522 NEWPORT AVE STE 102
Tustin, CA 92780

Reassigned Medicare billing, California enrollment

NPI 1093502148 (714) 388-6816

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 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

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

15 services13 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

15 services13 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

14 services12 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

14 services14 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

12 services12 patients

Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope 43238

An ultrasound guided needle aspiration or biopsy of the esophagus involves using a flexible tube with a camera (endoscope) to view your esophagus. An ultrasound device on the endoscope helps to guide a needle to take a small tissue sample for testing. This is a safe, minimally invasive procedure.

11 services11 patients

Removal of large bowel tissue using a flexible endoscope 45390

This procedure, known as a colonoscopy, involves using a flexible endoscope to examine and potentially remove tissue from the large intestine. The endoscope allows the doctor to view the bowel lining directly and remove any abnormal tissue for further analysis.

11 services11 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

Quality

93.33

Promoting Interoperability

100

Improvement Activities

Cost

54.91

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.

Which organizations bill Medicare for Ki-yoon Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ki-yoon Kim reassigns Medicare benefits to 5 organizations: San Diego Gastroenterology Medical Associates (San Diego, CA), Family Health Centers Of San Diego, Inc. (San Diego, CA), On Call Specialists Medical Group Of San Diego, Inc. (San Diego, CA), Chest And Critical Care Consultants (Tustin, CA) and Kyk Medical Professional Corporation (Tustin, 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 Ki-yoon 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 Ki-yoon Kim was last updated on October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.