DR. JERRY J KIM MD
NPI 1912295510
Surgery - Vascular Surgery in Pomona, CA

NPI Status: Active since July 16, 2011

Contact Information

350 VINTON AVE STE 202
POMONA, CA
ZIP 91767
Phone: (909) 909-1148
Fax: (909) 363-4954

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  • Individual
  • Male
  • Years of Experience 16
  • Surgery
  • Vascular Surgery
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JERRY KIM

This page provides the complete NPI Profile along with additional information for Jerry Kim, a provider established in Pomona, California with a medical specialization in Surgery, focusing in vascular surgery and more than 16 years of experience. He graduated from Baylor College Of Medicine in 2011. The healthcare provider is registered in the NPI registry with number 1912295510 assigned on July 2011. The practitioner's primary taxonomy code is 2086S0129X with license number A124130 (CA). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1912295510
Provider Name
DR. JERRY J KIM MD
Gender
Male
Entity Type
Individual
Location Address
350 VINTON AVE STE 202 POMONA, CA 91767
Location Phone
(909) 909-1148
Location Fax
(909) 363-4954
Mailing Address
350 VINTON AVE STE 202 POMONA, CA 91767
Mailing Phone
(909) 973-1148
Mailing Fax
(909) 363-4954
Medical School Name
BAYLOR COLLEGE OF MEDICINE
Graduation Year
2011
Is Sole Proprietor?
No
Enumeration Date
07-16-2011
Last Update Date
08-01-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Surgery Vascular Surgery

Taxonomy Code
2086S0129X
Type
Allopathic & Osteopathic Physicians
License No.
A124130
License State
CA
Taxonomy Description
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208600000XAllopathic & Osteopathic Physicians

Surgery

A124130 (CA)

Medicare Participation & PECOS Enrollment Status

Jerry Kim is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jerry Kim is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2062630924

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20140906000016

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Coronary artery bypass graft (CABG)

Coronary artery bypass graft (CABG) is a surgery to improve blood flow to your heart. It involves taking a blood vessel from another part of your body and using it to reroute blood around a blocked or narrowed artery in your heart. This can help reduce chest pain and minimize the risk of heart attacks.

This service was performed for 1-10 patients

Creation of artery-vein connection using tube graft for hemodialysis

This procedure involves connecting an artery to a vein using a tube graft. It's typically done for hemodialysis, a treatment for kidney disease. The connection allows blood to flow from the artery into the graft, then into the vein, and back to your body.

This service was performed 14 times for 14 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 103 times for 74 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 47 times for 45 patients

Leg revascularization (restoring blood flow)

Leg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.

This service was performed for 131 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 83 times for 83 patients

Relocation of arm vein with connection to arm artery for hemodialysis

This procedure involves moving a vein in your arm and connecting it to an artery. This creates a larger, stronger vein that can be used for hemodialysis, a treatment for kidney disease. It helps clean your blood when your kidneys can't.

This service was performed 13 times for 13 patients

Relocation of major upper arm vein with connection to arm artery for hemodialysis

This procedure adjusts your upper arm vein's position and connects it to an arm artery to improve blood flow. It's used for hemodialysis, a treatment that cleans your blood when your kidneys can't. It makes the dialysis process more efficient and comfortable.

This service was performed 17 times for 17 patients

Removal of tunneled central venous tube

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

This service was performed 16 times for 16 patients

Review by radiologist of arm or leg artery image

This procedure involves a radiologist examining images of your arm or leg arteries. These images are obtained through a non-invasive method, like an ultrasound or CT scan. The radiologist reviews these images to identify any abnormalities, such as blockages or narrowing, which can affect blood flow.

This service was performed 23 times for 14 patients

Revision of hemodialysis graft

A revision of a hemodialysis graft is a procedure to fix issues with the graft used for dialysis. This can involve clearing blockages or improving blood flow. It helps ensure the graft continues to work effectively for your dialysis treatments.

This service was performed 13 times for 13 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 1-10 patients

Ultrasonic guidance for blood vessel access

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

This service was performed 28 times for 17 patients

Varicose vein removal

Varicose vein removal is a procedure to eliminate enlarged and twisted veins, commonly found in legs. It's performed when these veins cause discomfort or skin problems. The procedure may involve laser treatment, sclerotherapy (injecting a solution to close the veins), or surgery to remove the veins. It's generally safe and helps to alleviate symptoms.

This service was performed for 20 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $24.09 for a new patient copayment and $19.49 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 91767 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $96.36
  • Minimum New Patient Price $62.96
  • Maximum New Patient Price $187.6
  • Average New Patient Copayment $24.09
  • Minimum New Patient Copayment $15.74
  • Maximum New Patient Copayment $46.9

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $77.96
  • Minimum Established Patient Price $20.84
  • Maximum Established Patient Price $153.61
  • Average Established Patient Copayment $19.49
  • Minimum Established Patient Copayment $5.21
  • Maximum Established Patient Copayment $38.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1912295510, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
1
Doubled → 2
Pos 4
2
Unchanged
Pos 5
2
Doubled → 4
Pos 6
9
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
1
Doubled → 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 2 + 2 + 4 + 9 + 1 + 0 + 5 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1912295510.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Surgery (Vascular Surgery)
350 VINTON AVE STE 202
POMONA, CA 91767
Surgery (Vascular Surgery)
350 VINTON AVE STE 202
POMONA, CA 91767

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912295510, enumerated as an "individual" on July 16, 2011.

The provider is located at 350 VINTON AVE STE 202 POMONA, CA 91767 and the phone number is (909) 909-1148.

Surgery with taxonomy code 2086S0129X and a focus in Vascular Surgery.