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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GRACE KIM
NPI 1770161465
Optometrist in Los Angeles, CA

Active since April 01, 2021PECOS EnrolledAccepts Medicare Assignment
11540 SANTA MONICA BLVD STE 202, LOS ANGELES, CA 90025(310) 473-5464 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 19, 2022, Apr 1, 2021 (2 updates tracked since 2021).

About Grace Kim NPPES

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

GRACE KIM (NPI 1770161465) is an individual optometrist in Los Angeles, California, licensed in California (35031TLG) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2021).

NPPES Registry Identity

NPI1770161465
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameGRACE KIM
Location Address11540 SANTA MONICA BLVD STE 202Los Angeles, CA 90025-7905
Mailing Address11540 Santa Monica Blvd Ste 202Los Angeles, CA 90025-7905
Phone(310) 473-5464
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2021
Enumeration DateApril 1, 2021
Last NPPES UpdateJune 23, 20262 updates tracked since enumeration
NPPES CertifiedJune 23, 2026
✔ NPI 1770161465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 35031TLG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
11540 SANTA MONICA BLVD STE 202, Los Angeles, CA 90025
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Grace 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.

PECOS PAC ID7517338056
PECOS Enrollment IDI20230120001380
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 90025 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
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 2

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

DR. CHAN NHU DIEP O.D.
Optometrist
11540 SANTA MONICA BLVD STE 202
LOS ANGELES, CA 90025
Los Angeles County (310) 473-5464
JENILEE LIANG
Optometrist
11540 SANTA MONICA BLVD STE 202
LOS ANGELES, CA 90025
Los Angeles County (310) 473-5464

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 Grace Kim's NPI number?

The NPI number for Grace Kim is 1770161465. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Where is Grace Kim located?

Grace Kim practices at 11540 Santa Monica Blvd Ste 202, Los Angeles, CA 90025. The listed phone number is (310) 473-5464.

What is Grace Kim's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Grace Kim enrolled in Medicare?

Yes. Grace 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.

What insurance does Grace Kim accept?

Health plans from Providence Health Plan list Grace Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grace Kim was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 days 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.