MYUNG KIM (MD) – Anesthesiology Physician, NPI 1104842640

MYUNG KIM (MD) is a healthcare provider. based in Modesto, California. specializing in Anesthesiology Physician. They hold the professional credentials MD. They hold a License No. G81752 (CA). The NPI Number for MYUNG KIM (MD) is 1104842640

Main info

Male
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
MYUNG KIM (MD)
NPI
1104842640
Phone
(209) 578-1211
Address
1441 FLORIDA AVE
Enumeration Date
15 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
Secondary Phone
2095781211
Graduation Year
1990 (36 years ago)
PAC ID
5193812592
Group Practice PAC ID
0941465322
Professional Enrollment ID
I20071101000578
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MYUNG KIM (MD)

  • Doctors Medical Center, 1441, Florida Avenue, Aurora, Modesto, Stanislaus County, California, 95350, United States

    MODESTO, CA 953504405

    Phone: (209) 578-1211

    Type: Location

  • PO BOX 28128

    FRESNO, CA 937298128

    Phone: (559) 436-0871

    Fax: (559) 436-5221

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2007-11-01

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
I20071101000578IAnesthesiologyCATBD

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 95350)

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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: 0941465322View full group profile
NameSpecialtyState
Internal MedicineCA
-CA
G A S T R O E N T E R O L O G YCA
-CA
Internal Medicine, Critical Care (Intensivists), Pulmonary Disease, Pulmonary DiseaseMD
O P T O M E T R YCA
O P T O M E T R YCA
O B S T E T R I C S/ G Y N E C O L O G YKY
Orthopedic SurgeryCA
Pulmonary Disease, Internal MedicineUT

Reviews

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Frequently asked questions

What is MYUNG KIM (MD)'s NPI number?
MYUNG KIM (MD)'s NPI is 1104842640 — the number used across U.S. healthcare to identify this provider.
Is there an active status for MYUNG KIM (MD)?
For scheduling context, MYUNG KIM (MD) is shown as active in the registry.
What expertise is attributed to MYUNG KIM (MD)?
MYUNG KIM (MD)'s specialty line reads Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Is MYUNG KIM (MD) associated with Modesto?
Public fields place MYUNG KIM (MD) around Modesto, California. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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