Ms Chanyoung Kim, - Medicare Nurse Practitioner in Los Angeles, CA

Ms Chanyoung Kim, is a medicare enrolled "Nurse Practitioner - Primary Care" in Los Angeles, California. Her current practice location is 266 S Harvard Blvd Ste 100, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (213) 381-8668.

Ms Chanyoung Kim is licensed to practice in California (license number 95004688) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003310517.

Contact Information

Ms Chanyoung Kim,
266 S Harvard Blvd Ste 100,
Los Angeles, CA 90004-4374
(213) 381-8668
Not Available



Provider's Profile

Full NameMs Chanyoung Kim
GenderFemale
SpecialityNurse Practitioner - Primary Care
Location266 S Harvard Blvd Ste 100, Los Angeles, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003310517
  • Provider Enumeration Date: 03/20/2018
  • Last Update Date: 03/20/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 5092078709
  • Enrollment ID: I20180411001084

Medical Identifiers

Medical identifiers for Ms Chanyoung Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003310517NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP2300XNurse Practitioner - Primary Care 95004688 (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. Ms Chanyoung Kim allows following entities to bill medicare on her behalf.
Entity NameY J Lee Md Corp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336581123
PECOS PAC ID: 5193955920
Enrollment ID: O20140224000343

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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. Ms Chanyoung 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 AddressPractice Location Address
Ms Chanyoung Kim,
266 S Harvard Blvd Ste 100,
Los Angeles, CA 90004-4374

Ph: (213) 381-8668
Ms Chanyoung Kim,
266 S Harvard Blvd Ste 100,
Los Angeles, CA 90004-4374

Ph: (213) 381-8668

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Practice Location: 3000 E 1st St, Los Angeles, CA 90063
Phone: 323-262-6935    Fax: 323-262-3109
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