Jiyeon Kim, NURSE PRACTITIONER - Medicare Nurse Practitioner in Reseda, CA

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Jiyeon Kim, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner" in Reseda, California. Her current practice location is 18107 Sherman Way Ste 200, Reseda, California. You can reach out to her office (for appointments etc.) via phone at (818) 783-1002.

Jiyeon Kim is licensed to practice in California (license number 95006590) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043780216.

Contact Information

Jiyeon Kim, NURSE PRACTITIONER
18107 Sherman Way Ste 200,
Reseda, CA 91335-8802
(818) 783-1002
Not Available

Map and Direction




Provider's Profile

Full NameJiyeon Kim
GenderFemale
SpecialityNurse Practitioner
Location18107 Sherman Way Ste 200, Reseda, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1043780216
  • Provider Enumeration Date: 11/30/2018
  • Last Update Date: 03/31/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 4789924713
  • Enrollment ID: I20190328002553

Medical Identifiers

Medical identifiers for Jiyeon Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043780216NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 95006590 (California)Primary

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. Jiyeon Kim allows following entities to bill medicare on her behalf.
Entity NameCentral California Faculty Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457603573
PECOS PAC ID: 8325952773
Enrollment ID: O20031118001168
Entity NameUniversity Faculty Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073911137
PECOS PAC ID: 6507181708
Enrollment ID: O20150211000164
Entity NamePacific Advanced Kidney Solutions Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992160501
PECOS PAC ID: 0547556003
Enrollment ID: O20160908002413

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. Jiyeon 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 AddressPractice Location Address
Jiyeon Kim, NURSE PRACTITIONER
18107 Sherman Way Ste 200,
Reseda, CA 91335-8802

Ph: (818) 783-1112		Jiyeon Kim, NURSE PRACTITIONER
18107 Sherman Way Ste 200,
Reseda, CA 91335-8802

Ph: (818) 783-1002

Reviews and Comments


Nurse Practitioner Nurses in Reseda, CA

Mr. Elizabeth Salazar, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6906 Topeka Dr, Reseda, CA 91335
Phone: 818-454-5973    
Adrean Kentray Knight, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 7150 Tampa Ave, Reseda, CA 91335
Phone: 888-227-3745    
Ms. Lydia Kay Wilson, GNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 18855 Victory Blvd, Attn: Billing Department, Reseda, CA 91335
Phone: 818-774-3354    Fax: 818-757-4401
Shenelle Gunatilake,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 18908 Strathern St, Reseda, CA 91335
Phone: 818-414-1175    
Mrs. Elizabeth Videla Lalane, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 19353 Victory Blvd., Reseda, CA 91335
Phone: 818-996-4742    
Patricia Jeng,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 18040 Sherman Way, Suite 200, Reseda, CA 91335
Phone: 818-212-2223    Fax: 818-212-2224

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.