David Kim, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Lake Balboa, California. He graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is
16723 Vanowen St, Lake Balboa, California. You can reach out to his office (for appointments etc.) via phone at
(818) 279-1745.
David Kim is licensed to practice in California (license number 95021554) 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 1447967682.
Provider's Profile
| Full Name | David Kim |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 16723 Vanowen St, Lake Balboa, 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:
- David Kim graduated from nursing school in 2022
NPI Data:
- NPI Number: 1447967682
- Provider Enumeration Date: 10/27/2022
- Last Update Date: 12/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042678740
- Enrollment ID: I20230627002360
Medical Identifiers
Medical identifiers for David Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1447967682 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2100X | Nurse Practitioner - Acute Care | 95021554 (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 | 9038 |
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. David 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 | Mend Health Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467849745
PECOS PAC ID: 6406160803
Enrollment ID: O20150729008949 |
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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. David 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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David Kim, AGACNP-BC
16723 Vanowen St,
Lake Balboa, CA 91406-4638
Ph: (818) 279-1745 | David Kim, AGACNP-BC
16723 Vanowen St,
Lake Balboa, CA 91406-4638
Ph: (818) 279-1745 |
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