Wayne W Kim, DO is a medicare enrolled "Clinic/center - Federally Qualified Health Center (fqhc)" physician in Stanton, California. His current practice location is
12362 Beach Blvd Ste 10, Stanton, California. You can reach out to his office (for appointments etc.) via phone at
(714) 248-9500.
Wayne W Kim is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619987054.
Physician's Profile
| Full Name | Wayne W Kim |
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| Gender | Male |
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| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
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| Location | 12362 Beach Blvd Ste 10, Stanton, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1619987054
- Provider Enumeration Date: 08/08/2006
- Last Update Date: 09/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 1557335387
- Enrollment ID: I20220928002700
Medical Identifiers
Medical identifiers for Wayne W Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619987054 | NPI | - | NPPES |
| PENDING | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | OP00001562 (Washington) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | OP00001562 (Washington) | Secondary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | 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. Wayne W Kim allows following entities to bill medicare on his behalf.
| Entity Name | Livingstone Community Development Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952662686
PECOS PAC ID: 9931323706
Enrollment ID: O20140724002386 |
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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. Wayne W 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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Wayne W Kim, DO
12362 Beach Blvd Ste 10,
Stanton, CA 90680-3944
Ph: (714) 248-9500 | Wayne W Kim, DO
12362 Beach Blvd Ste 10,
Stanton, CA 90680-3944
Ph: (714) 248-9500 |
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