SAMUEL KIM
NPI 1750146536
Nurse Practitioner - Family in Weimar, CA
About Samuel Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL KIM (NPI 1750146536) is an individual family provider in Weimar, California, licensed in California (95028798) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS and is a graduate of Emory University School Of Medicine (2023).
NPPES Registry Identity
Specialties & Licenses
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
Samuel Kim 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.
Medicare Billing Reassignments
2Medicare enrollment records show Samuel Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Weimar, CA 95736
- Reassigned Medicare billing, California enrollment
- 39 clinicians in this Medicare group
Los Angeles, CA 90031
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: St. John's Community Health
- 404 clinicians in this Medicare group
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 95736 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Samuel Kim's NPI number?
The NPI number for Samuel Kim is 1750146536. It was assigned to this individual provider in the NPPES registry on February 20, 2024.
Where is Samuel Kim located?
Samuel Kim practices at 20601 West Paoli Ln, Weimar, CA 95736. The listed phone number is (530) 637-4025.
What is Samuel Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Samuel Kim enrolled in Medicare?
Yes. Samuel 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 Samuel Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Kim reassigns Medicare benefits to 2 organizations: Newstart Medical Group Inc (Weimar, CA) and St. Johns Community Health (Los Angeles, 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 Samuel 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 Samuel Kim was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Samuel Kim · NPI 1750146536
Family physician in Weimar, California. Individual provider, active in the CMS NPPES registry since February 20, 2024.
## Identity
- **NPI:** 1750146536 (Entity type: Individual)
- **Enumerated:** February 20, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95028798 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 20601 WEST PAOLI LN, Weimar, CA 95736
- **Phone:** (530) 637-4025
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Newstart Medical Group Inc (NPI 1588072698, Weimar, CA); St. Johns Community Health (NPI 1932249505, Los Angeles, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Emory University School Of Medicine, class of 2023
## Record status
- **NPPES last updated:** February 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1750146536) · Data from the CMS NPPES public registry.