KORTREZ KING NP
NPI 1639879703
Nurse Practitioner - Family in Long Beach, CA

Q: What is Kortrez King's NPI number?

The NPI number for Kortrez King is 1639879703. It was assigned to this individual provider in the NPPES registry on March 7, 2023.

Q: What is Kortrez King's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kortrez King was last updated on March 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 07, 2023PECOS Enrolled

200 OCEANGATE STE 100, LONG BEACH, CA 90802(888) 562-5442 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 4, 2025, Mar 7, 2023 (2 updates tracked since 2023).

On this page

About Kortrez King Np NPPES

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

KORTREZ KING NP (NPI 1639879703) is an individual family provider in Long Beach, California, licensed in Michigan (4704319078) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Norton Shores, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1639879703

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameKORTREZ KINGCredential: NP

Location Address200 OCEANGATE STE 100Long Beach, CA 90802-4317

Mailing Address876 Seminole RdNorton Shores, MI 49441-4340 · (231) 903-2044

Phone(888) 562-5442

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 7, 2023

Last NPPES UpdateMarch 4, 20252 updates tracked since enumeration

NPPES CertifiedMarch 4, 2025

✔ NPI 1639879703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in MI · 4704319078✔ Licensed in MI · 4704319078NSA2304W

Also ListedRegistered NurseTaxonomy 163W00000X · License 4704319078 (MI)

200 OCEANGATE STE 100, Long Beach, CA 90802

Open in Google Maps ↗

Secondary Practice Location 1

Location 1876 Seminole RdNorton Shores, MI 49441-4340 · Phone (231) 903-2044

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kortrez King Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911428446

PECOS Enrollment IDI20260430003406

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 90802 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

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.