Hyunjib Kim, NURSE PRACTITIONER in Los Angeles, CA

Hyunjib Kim, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Los Angeles, California. His current practice location is 4211 Avalon Blvd, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at (323) 233-0425.

Hyunjib Kim is licensed to practice in California (license number 95022903) 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 1659097459.

Contact Information

	Hyunjib Kim, NURSE PRACTITIONER
	4211 Avalon Blvd, Los Angeles, CA 90011-5622
	(323) 233-0425
	Not Available

Map and Direction

Provider's Profile

Full Name	Hyunjib Kim
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	4211 Avalon Blvd, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659097459
Provider Enumeration Date: 10/13/2022
Last Update Date: 06/07/2023

Medicare PECOS Information:

PECOS PAC ID: 0042676025
Enrollment ID: I20230517001415

Medical Identifiers

Medical identifiers for Hyunjib Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659097459	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95022903 (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. Hyunjib Kim allows following entities to bill medicare on his behalf.

Entity Name	Ehab Yacoub Md Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417373713 PECOS PAC ID: 5092099523 Enrollment ID: O20170301002071

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. Hyunjib 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
Hyunjib Kim, NURSE PRACTITIONER 3643 W 133rd St, Hawthorne, CA 90250-6217 Ph: (213) 605-0433	Hyunjib Kim, NURSE PRACTITIONER 4211 Avalon Blvd, Los Angeles, CA 90011-5622 Ph: (323) 233-0425

Reviews and Comments

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Hyunjib Kim, NURSE PRACTITIONER - Medicare Nurse Practitioner in Los Angeles, CA