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MRS. HAESOOK KIM NP
NPI 1972020824
Nurse Practitioner in Walnut Creek, CA

Active since August 23, 2017PECOS Enrolled
2123 YGNACIO VALLEY RD STE K200, WALNUT CREEK, CA 94598(925) 926-0195(925) 926-0194 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Aug 23, 2017 (2 updates tracked since 2017).

About Mrs. Haesook Kim Np NPPES

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

MRS. HAESOOK KIM NP (NPI 1972020824) is an individual nurse practitioner in Walnut Creek, California, licensed in California (95004733) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1972020824
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. HAESOOK KIMCredential: NP
Location Address2123 YGNACIO VALLEY RD STE K200Walnut Creek, CA 94598-3336
Mailing Address2123 Ygnacio Valley Rd Ste K200Walnut Creek, CA 94598-3336 · (925) 926-0195 · Fax (925) 926-0194
Phone(925) 926-0195
Fax(925) 926-0194
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateAugust 23, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1972020824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95004733
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
2123 YGNACIO VALLEY RD STE K200, Walnut Creek, CA 94598
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Haesook Kim Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608258413
PECOS Enrollment IDI20220726002674
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Haesook Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The West Oakland Health Council
14 mi
Federally Qualified Health Center (FQHC)
7450 INTERNATIONAL BLVD
Oakland, CA 94621
  • Reassigned Medicare billing, California enrollment
  • 48 clinicians in this Medicare group
NPI 1285754234 (510) 430-9401
Brighter Beginnings
15 mi
Community/Behavioral Health
2744 E 11TH ST STE E01
Oakland, CA 94601
  • Reassigned Medicare billing, California enrollment
  • 23 clinicians in this Medicare group
NPI 1629275839 (510) 437-8950

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 94598 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
Most-billed visit code 99214
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

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

ANGELA JEANINE WILSON PA
Physician Assistant
2123 YGNACIO VALLEY RD STE K200
WALNUT CREEK, CA 94598
Contra Costa County (925) 926-0195

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 Haesook Kim's NPI number?

The NPI number for Haesook Kim is 1972020824. It was assigned to this individual provider in the NPPES registry on August 23, 2017.

Where is Haesook Kim located?

Haesook Kim practices at 2123 Ygnacio Valley Rd Ste K200, Walnut Creek, CA 94598. The listed phone number is (925) 926-0195.

What is Haesook Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Haesook Kim enrolled in Medicare?

Yes. Haesook Kim is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Haesook Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Haesook Kim reassigns Medicare benefits to 2 organizations: The West Oakland Health Council (Oakland, CA) and Brighter Beginnings (Oakland, 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 Haesook 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 Haesook Kim was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.