1. Home
  2. Directory
  3. California
  4. La Jolla
  5. Pediatrics
  6. NPI Profile

SHANNON LEUNG KIM
NPI 1588077564
Pediatrics in La Jolla, CA

Active since June 06, 2014PECOS Enrolled
8910 VILLA LA JOLLA DRIVE, SUITE 110, LA JOLLA, CA 92037(858) 203-4962 Get Directions Write a Review

NPPES record last updated: September 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 28, 2022, May 17, 2021, Mar 17, 2018 and 1 more (4 updates tracked since 2018).

About Shannon Leung Kim NPPES

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

SHANNON LEUNG KIM (NPI 1588077564) is an individual pediatrics provider in La Jolla, California, licensed in California (A162026) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588077564
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSHANNON LEUNG KIM
Location Address8910 VILLA LA JOLLA DRIVE, SUITE 110La Jolla, CA 92037
Mailing Address7910 Frost Street, Suite 350San Diego, CA 92123 · (858) 496-4800
Phone(858) 203-4962
Sole ProprietorNo
Enumeration DateJune 6, 2014
Last NPPES UpdateSeptember 28, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2022
✔ NPI 1588077564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A162026
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
8910 VILLA LA JOLLA DRIVE, La Jolla, CA 92037
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Leung Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92037 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
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.

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 Shannon Kim's NPI number?

The NPI number for Shannon Kim is 1588077564. It was assigned to this individual provider in the NPPES registry on June 6, 2014.

Where is Shannon Kim located?

Shannon Kim practices at 8910 Villa La Jolla Drive Suite 110, La Jolla, CA 92037. The listed phone number is (858) 203-4962.

What is Shannon Kim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Shannon Kim enrolled in Medicare?

Yes. Shannon Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Kim was last updated on September 28, 2022. 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.