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MONA KIM RN, MS, MA, PMHNP-BC
NPI 1639578487
Nurse Practitioner - Psychiatric/Mental Health in Oakland, CA

Active since August 18, 2014PECOS Enrolled
1422 HARRISON ST, OAKLAND, CA 94612(510) 809-1780(510) 893-1642 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 3, 2022, Mar 26, 2016, Feb 9, 2016 (3 updates tracked since 2016).

About Mona Kim Rn, Ms, Ma, Pmhnp-bc NPPES

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

MONA KIM RN, MS, MA, PMHNP-BC (NPI 1639578487) is an individual psychiatric/mental health provider in Oakland, California, licensed in California (NP95003523) and active in the NPI registry since August 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639578487
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMONA KIMCredential: RN, MS, MA, PMHNP-BC
Location Address1422 HARRISON STOakland, CA 94612-3903
Mailing Address1422 Harrison StOakland, CA 94612-3903 · (510) 809-1780 · Fax (510) 893-1642
Phone(510) 809-1780
Fax(510) 893-1642
Sole ProprietorNo
Enumeration DateAugust 18, 2014
Last NPPES UpdateJanuary 3, 20223 updates tracked since enumeration
✔ NPI 1639578487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · NP95003523
1422 HARRISON ST, Oakland, CA 94612
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mona Kim Rn, Ms, Ma, Pmhnp-bc 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.

Medicare Billing Reassignment

Medicare enrollment records show Mona Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
9.6 mi
Internal Medicine
2238 GEARY
San Francisco, CA 94116
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1841373800 (415) 833-2200

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 94612 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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 20

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

ROCHELLE GUMBS
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
MR. DEREK RENAUD ULRICH ESQ.
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
ELEANOR TANNIS
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
FOONGYEE KWAN DOUGLAS
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
DANIEL COOPERMAN
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
PORSCHA GULLEY
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
KATHLEEN ELIZABETH FRASER
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780
ANDREA TAMIKO INOUYE
Specialist
1422 HARRISON ST
OAKLAND, CA 94612
Alameda County (510) 809-1780

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 Mona Kim's NPI number?

The NPI number for Mona Kim is 1639578487. It was assigned to this individual provider in the NPPES registry on August 18, 2014.

Where is Mona Kim located?

Mona Kim practices at 1422 Harrison St, Oakland, CA 94612. The listed phone number is (510) 809-1780.

What is Mona Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mona Kim enrolled in Medicare?

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

Which organization bills Medicare for Mona Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mona Kim reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, CA). The 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 Mona 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 Mona Kim was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.