ALICE KISUN KIM PMHNP
NPI 1770362998
Nurse Practitioner - Psychiatric/Mental Health in Fullerton, CA
About Alice Kisun Kim Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALICE KISUN KIM PMHNP (NPI 1770362998) is an individual psychiatric/mental health provider in Fullerton, California, licensed in California (95027340) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS and is a graduate of Other (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
Alice Kisun Kim Pmhnp 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
4Medicare enrollment records show Alice Kim reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Anaheim, CA 92801
- Reassigned Medicare billing, California enrollment
- 40 clinicians in this Medicare group
Anaheim, CA 92801
- Reassigned Medicare billing, California enrollment
- 26 clinicians in this Medicare group
Lake Forest, CA 92630
- Reassigned Medicare billing, California enrollment
- 3 clinicians in this Medicare group
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 3,139 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 92833 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Alice Kim's NPI number?
The NPI number for Alice Kim is 1770362998. It was assigned to this individual provider in the NPPES registry on September 26, 2023.
Where is Alice Kim located?
Alice Kim practices at 2558 Tiffany Pl, Fullerton, CA 92833. The listed phone number is (213) 200-3500.
What is Alice Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Alice Kim enrolled in Medicare?
Yes. Alice 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 Alice Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alice Kim reassigns Medicare benefits to 4 organizations: Mental Health And Nursing PC (Anaheim, CA), Renewed Medical Group, A Professional Medical Corporation (Anaheim, CA), Karen Rightler, Pmhnp-Bc, A Professional Nursing Corporation (Lake Forest, CA) and Grow Healthcare Group PC (San Jose, 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 Alice 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 Alice Kim was last updated on September 26, 2023. 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.
# Alice Kisun Kim, PMHNP · NPI 1770362998
Psychiatric/Mental Health physician in Fullerton, California. Individual provider, active in the CMS NPPES registry since September 26, 2023.
## Identity
- **NPI:** 1770362998 (Entity type: Individual)
- **Enumerated:** September 26, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 95027340 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2558 TIFFANY PL, Fullerton, CA 92833-1527
- **Phone:** (213) 200-3500
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Mental Health And Nursing PC (NPI 1528693579, Anaheim, CA); Renewed Medical Group, A Professional Medical Corporation (NPI 1922785690, Anaheim, CA); Karen Rightler, Pmhnp-Bc, A Professional Nursing Corporation (NPI 1164115986, Lake Forest, CA); Grow Healthcare Group PC (NPI 1154994846, San Jose, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** September 26, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1770362998) · Data from the CMS NPPES public registry.