Dr Dong Won Kim, MD, PHD is a medicare enrolled "Radiology - Radiation Oncology" physician in Ontario, California. He went to Loma Linda University School Of Medicine and graduated in 2003 and has 21 years of diverse experience with area of expertise as Radiation Oncology. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is
2295 S Vineyard Ave, Ontario, California. You can reach out to his office (for appointments etc.) via phone at
(909) 724-2020.
Dr Dong Won Kim is licensed to practice in California (license number A104479) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1386816262.
Physician's Profile
| Full Name | Dr Dong Won Kim |
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| Gender | Male |
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| Speciality | Radiation Oncology |
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| Experience | 21 Years |
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| Location | 2295 S Vineyard Ave, Ontario, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Dong Won Kim attended and graduated from Loma Linda University School Of Medicine in 2003
NPI Data:
- NPI Number: 1386816262
- Provider Enumeration Date: 03/31/2008
- Last Update Date: 11/02/2021
Medicare PECOS Information:
- PECOS PAC ID: 1557420692
- Enrollment ID: I20081105000129
Medical Identifiers
Medical identifiers for Dr Dong Won Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386816262 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0001X | Radiology - Radiation Oncology | A104479 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southern California Permanente Medical Group | 6002729175 | 7951 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Dong Won Kim allows following entities to bill medicare on his behalf.
| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678 |
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| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Dong Won Kim is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Dong Won Kim, MD, PHD
Po Box 51802,
Irvine, CA 92619-1802
Ph: (919) 641-6207 | Dr Dong Won Kim, MD, PHD
2295 S Vineyard Ave,
Ontario, CA 91761-7925
Ph: (909) 724-2020 |
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