WAYNE W KIM D.O.
NPI 1619987054
Clinic/Center - Federally Qualified Health Center (FQHC) in Stanton, CA

Q: What is Wayne Kim's NPI number?

The NPI number for Wayne Kim is 1619987054. It was assigned to this individual provider in the NPPES registry on August 8, 2006.

Q: What is Wayne Kim's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Q: When was this NPI record last updated?

The NPPES record for Wayne Kim was last updated on September 14, 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.

Active since August 08, 2006PECOS Enrolled

12362 BEACH BLVD STE 10, STANTON, CA 90680(714) 248-9500(714) 622-4943 Get Directions Write a Review

NPPES record last updated: September 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Wayne W Kim D.o. NPPES

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

WAYNE W KIM D.O. (NPI 1619987054) is an individual federally qualified health center (fqhc) provider in Stanton, California and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Spanaway.

NPPES Registry Identity

NPI1619987054

Entity TypeIndividualMale

Primary Taxonomy261QF0400X

Provider Legal NameWAYNE W KIMCredential: D.O.

Location Address12362 BEACH BLVD STE 10Stanton, CA 90680-3944

Mailing Address12362 Beach Blvd Ste 10Stanton, CA 90680-3944 · (714) 248-9500 · Fax (714) 622-4943

Phone(714) 248-9500

Fax(714) 622-4943

Sole ProprietorYes

Enumeration DateAugust 8, 2006

Last NPPES UpdateSeptember 14, 2022

NPPES CertifiedSeptember 14, 2022

✔ NPI 1619987054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedFamily MedicineTaxonomy 207Q00000X · License OP00001562 (WA)

Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X · License OP00001562 (WA)

Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X

12362 BEACH BLVD STE 10, Stanton, CA 90680

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Secondary Practice Location 1

Location 1144 169th St S Ste ASpanaway, WA 98387-8242 · Phone (253) 536-2824 · Fax (253) 536-3070

Other Identifiers 1

MedicaidPENDINGCA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wayne W Kim D.o. 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 90680 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

$187.60 typical visit price

range $62.96 – $187.60

Typical copayment $46.90 (range $15.74 – $46.90)

Most-billed visit code 99205

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.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JUSTIN TONY CHUNG D.D.S.

Dentist