Jeong Su Kim, OD in Pacifica, CA - Medicare Optometrist Provider

Jeong Su Kim, OD is a medicare enrolled "Optometrist" provider in Pacifica, California. His current practice location is 769 Hickey Blvd, Pacifica, California. You can reach out to his office (for appointments etc.) via phone at (650) 738-2205.

Jeong Su Kim is licensed to practice in California (license number 35621) 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 1245009141.

Contact Information

	Jeong Su Kim, OD
	769 Hickey Blvd, Pacifica, CA 94044-1214
	(650) 738-2205
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jeong Su Kim
Gender	Male
Speciality	Optometrist
Location	769 Hickey Blvd, Pacifica, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245009141
Provider Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023

Medicare PECOS Information:

PECOS PAC ID: 8224478144
Enrollment ID: I20240425002449

Medical Identifiers

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

Identifier	Type	State	Issuer
1245009141	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	35621 (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. Jeong Su Kim allows following entities to bill medicare on his behalf.

Provider Name	Jennifer Quirante, Professional Optometry Corp
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1003902842 PECOS PAC ID: 8921069097 Enrollment ID: O20041021000901

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. Jeong Su 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
Jeong Su Kim, OD 1530 15th Ave Unit 202, Seattle, WA 98122-4035 Ph: () -	Jeong Su Kim, OD 769 Hickey Blvd, Pacifica, CA 94044-1214 Ph: (650) 738-2205

Reviews and Comments

Optometrist in Pacifica, CA

Rockaway Beach Optometry Optometrist Medicare: Medicare Enrolled Practice Location: 769 Hickey Blvd, Pacifica, CA 94044 Phone: 650-738-2205 Fax: 650-738-2203
Susan Pi-shian Hsu, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2014 Palmetto Ave, Ste B, Pacifica, CA 94044 Phone: 650-359-2231 Fax: 650-359-2305
Dr. Jennifer Quirante, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 769 Hickey Blvd, Pacifica, CA 94044 Phone: 650-738-2205 Fax: 650-738-2203
Pacifica Sun Optometry Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2014 Palmetto Ave Ste B, Pacifica, CA 94044 Phone: 415-810-9140
Laimeng Lee, Optometrist Medicare: Medicare Enrolled Practice Location: 1335 Linda Mar Shopping Ctr, Pacifica, CA 94044 Phone: 650-738-2205
Dan Thy Tran, OD Optometrist Medicare: Medicare Enrolled Practice Location: 769 Hickey Blvd, Pacifica, CA 94044 Phone: 650-738-2205

Jeong Su Kim, OD - Medicare Optometrist in Pacifica, CA