DR. STANLEY TAESON KIM M.D.
NPI 1790779791
Radiology - Vascular & Interventional Radiology in Madera, CA
About Dr. Stanley Taeson Kim M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STANLEY TAESON KIM M.D. (NPI 1790779791) is an individual vascular & interventional radiology provider in Madera, California, licensed in California (C151887) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Rush Medical College Of Rush University (1999).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 2
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
Dr. Stanley Taeson Kim M.d. 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
12Medicare enrollment records show Stanley Kim reassigns Medicare billing to 12 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fresno, CA 93710
- Reassigned Medicare billing, California enrollment
- 232 clinicians in this Medicare group
Fresno, CA 93710
- Reassigned Medicare billing, California enrollment
- 17 clinicians in this Medicare group
Modesto, CA 95350
- Reassigned Medicare billing, California enrollment
- 219 clinicians in this Medicare group
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 219 clinicians in this Medicare group
Fremont, CA 94538
- Reassigned Medicare billing, California enrollment
- 238 clinicians in this Medicare group
Sacramento, CA 95825
- Reassigned Medicare billing, California enrollment
- 220 clinicians in this Medicare group
San Francisco, CA 94118
- Reassigned Medicare billing, California enrollment
- 219 clinicians in this Medicare group
Santa Rosa, CA 95403
- Reassigned Medicare billing, California enrollment
- 222 clinicians in this Medicare group
Van Nuys, CA 91405
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Beverly Radiology Medical Group Iii
- Also billed through NPI 1962457812 (California)
- 335 clinicians in this Medicare group
Encino, CA 91436
- Reassigned Medicare billing, California enrollment
- 329 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 93636 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
MADERA, CA 93636
MADERA, CA 93636
MADERA, CA 93636
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 Stanley Kim's NPI number?
The NPI number for Stanley Kim is 1790779791. It was assigned to this individual provider in the NPPES registry on September 6, 2005.
Where is Stanley Kim located?
Stanley Kim practices at 9300 Valley Childrens Pl, Madera, CA 93636. The listed phone number is (559) 485-8330.
What is Stanley Kim's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.
Is Stanley Kim enrolled in Medicare?
Yes. Stanley 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 Stanley Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stanley Kim reassigns Medicare benefits to 12 organizations: Fresno Imaging Center (Fresno, CA), Wishon Radiological Medical Group, Inc. (Fresno, CA), Modesto Advanced Diagnostic Imaging Medical Center (Modesto, CA), Stockton Diagnostic Imaging (Stockton, CA), Norcal Imaging (Fremont, CA) and 7 more organizations, listed in the Medicare section above. 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 Stanley 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 Stanley Kim was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 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.
# Dr. Stanley Taeson Kim, M.D. · NPI 1790779791
Vascular & Interventional Radiology physician in Madera, California. Individual provider, active in the CMS NPPES registry since September 6, 2005.
## Identity
- **NPI:** 1790779791 (Entity type: Individual)
- **Enumerated:** September 6, 2005
- **Primary specialty:** Radiology - Vascular & Interventional Radiology · taxonomy 2085R0204X
- **State license:** C151887 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 9300 VALLEY CHILDRENS PL, Madera, CA 93636-8762
- **Phone:** (559) 485-8330
## 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:** 12 organizations under Medicare reassignment (form CMS-855R): Fresno Imaging Center (NPI 1659456499, Fresno, CA); Wishon Radiological Medical Group, Inc. (NPI 1528012168, Fresno, CA); Modesto Advanced Diagnostic Imaging Medical Center (NPI 1730133893, Modesto, CA); Stockton Diagnostic Imaging (NPI 1356538201, Stockton, CA); Norcal Imaging (NPI 1013031772, Fremont, CA); and 7 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Rush Medical College Of Rush University, class of 1999
## Record status
- **NPPES last updated:** September 29, 2026
- **Other identifiers:** Other 021622158 (IL); Medicaid 036111178 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1790779791) · Data from the CMS NPPES public registry.