DANIEL E KIM (PA-C) – Physician Assistant, NPI 1013513811

DANIEL E KIM (PA-C) is a healthcare provider. based in San bernardino, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for DANIEL E KIM (PA-C) is 1013513811

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DANIEL E KIM (PA-C)
NPI
1013513811
Phone
(909) 883-1098
Address
284 E HIGHLAND AVE
Enumeration Date
7 December 2020
Last Update Date
23 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7145036550
Graduation Year
2021 (5 years ago)
PAC ID
1850791427
Group Practice PAC ID
0446495105
Professional Enrollment ID
I20210618000778
Address ID
CA928052912AN451XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

10,564 PHYSICIAN ASSISTANT in CA

Provider Addresses for DANIEL E KIM (PA-C)

  • 284 E HIGHLAND AVE

    SAN BERNARDINO, CA 924043706

    Phone: (909) 883-1098

    Fax: (909) 883-0653

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $220.

Total Amount is formed as General ($220) + Research ($0) + Ownership ($0) = $220.

Last reported payment date: 2023-11-08 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($125).

Total Amount

$220

General + Research + Ownership

Payments

2

Total payment records

General Amount

$220

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-08

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-06-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210618000778IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446495105View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Addiction Medicine, Preventive MedicineCA
Marriage And Family TherapistCA
Nurse PractitionerCA
Addiction MedicineUT
Nurse PractitionerCA
Nurse PractitionerCA
Family PracticeCA

Reviews

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Frequently asked questions

Is there an official ID for DANIEL E KIM (PA-C) in U.S. healthcare records?
The official identifier for DANIEL E KIM (PA-C) is NPI 1013513811.
Would DANIEL E KIM (PA-C) appear as active to a payer?
You can treat DANIEL E KIM (PA-C) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DANIEL E KIM (PA-C)?
DANIEL E KIM (PA-C)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DANIEL E KIM (PA-C)?
Travel planning: use San Bernardino, California as the reference point for DANIEL E KIM (PA-C), then confirm.
When was this NPI issued?
Enumeration for DANIEL E KIM (PA-C) is noted as December 7, 2020 where the registry provides it.

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