Dr Jack Son Kim, OD in Buena Park, CA - Medicare Optometrist Provider

Dr Jack Son Kim, OD is a medicare enrolled "Optometrist" provider in Buena Park, California. His current practice location is 5832 Beach Blvd Unit 109, Buena Park, California. You can reach out to his office (for appointments etc.) via phone at (714) 228-1888.

Dr Jack Son Kim is licensed to practice in California (license number 13848) 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 1679808356.

Contact Information

	Dr Jack Son Kim, OD
	5832 Beach Blvd Unit 109, Buena Park, CA 90621-5500
	(714) 228-1888
	(714) 676-8308

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jack Son Kim
Gender	Male
Speciality	Optometrist
Location	5832 Beach Blvd Unit 109, Buena Park, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679808356
Provider Enumeration Date: 10/13/2009
Last Update Date: 01/09/2025

Medicare PECOS Information:

PECOS PAC ID: 6608906516
Enrollment ID: I20100618000511

Medical Identifiers

Medical identifiers for Dr Jack Son Kim such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679808356	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	13848 (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. Dr Jack Son Kim allows following entities to bill medicare on his behalf.

Provider Name	Eyecare Medical Corporation
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1427016120 PECOS PAC ID: 4981597481 Enrollment ID: O20040206000942

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 Jack Son 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
Dr Jack Son Kim, OD 6495 Saipan St, Cypress, CA 90630-5620 Ph: (626) 388-7391	Dr Jack Son Kim, OD 5832 Beach Blvd Unit 109, Buena Park, CA 90621-5500 Ph: (714) 228-1888

Reviews and Comments

Optometrist in Buena Park, CA

Firstsigth Vision Services, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 8450 La Palma Ave, Buena Park, CA 90620 Phone: 714-527-9236 Fax: 714-527-5873
Dr. Joseph Sik Pak, OD Optometrist Medicare: Medicare Enrolled Practice Location: 6850 Lincoln Ave Ste 204, Buena Park, CA 90620 Phone: 714-927-5192 Fax: 253-252-8801
Dr. Dana Y Phan, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 8951 Knott Ave Ste K, Buena Park, CA 90620 Phone: 714-797-1896
Dr. Hoangnhan Le, O.d., Inc. Optometrist Medicare: Medicare Enrolled Practice Location: 5811 Beach Blvd, Buena Park, CA 90621 Phone: 714-521-7582
Roy Optometry Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5426 Beach Blvd, Buena Park, CA 90621 Phone: 714-522-1001
Sudheshna Miryala, Optometrist Medicare: Not Enrolled in Medicare Practice Location: 8415 Pierce Dr, Buena Park, CA 90620 Phone: 714-470-8857
Tricia Kawaguchi, Od, Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 8450 La Palma Ave, Buena Park, CA 90620 Phone: 714-527-9236

Dr Jack Son Kim, OD - Medicare Optometrist in Buena Park, CA