Jae Yoon Kim, is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in South San Francisco, California. His current practice location is
1200 El Camino Real, South San Francisco, California. You can reach out to his office (for appointments etc.) via phone at
(650) 742-2000.
Jae Yoon Kim is licensed to practice in Ohio (license number 36.004128) 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 1013595107.
Healthcare Provider's Profile
| Full Name | Jae Yoon Kim |
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| Gender | Male |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 1200 El Camino Real, South San Francisco, 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: 1013595107
- Provider Enumeration Date: 03/30/2021
- Last Update Date: 09/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 9739521493
- Enrollment ID: I20240525000100
Medical Identifiers
Medical identifiers for Jae Yoon Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1013595107 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 36.004128 (Ohio) | Primary |
| 261QP1100X | Clinic/center - Podiatric | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 213E00000X | Podiatrist | 36.004128 (Ohio) | Secondary |
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. Jae Yoon Kim allows following entities to bill medicare on his behalf.
| Provider Name | Beacon Orthopaedics & Sports Medicine Ltd |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1386670065
PECOS PAC ID: 0345136412
Enrollment ID: O20040225000690 |
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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. Jae Yoon 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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Jae Yoon Kim,
1200 El Camino Real,
South San Francisco, CA 94080-3299
Ph: (650) 742-2000 | Jae Yoon Kim,
1200 El Camino Real,
South San Francisco, CA 94080-3299
Ph: (650) 742-2000 |
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