JOON MYUNG KIM (DC) – Chiropractor, NPI 1205343548

JOON MYUNG KIM (DC) is a healthcare provider. based in Montclair, California. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. 33821 (CA). The NPI Number for JOON MYUNG KIM (DC) is 1205343548

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
JOON MYUNG KIM (DC)
NPI
1205343548
Phone
(909) 626-7100
Address
4959 PALO VERDE ST STE 100B
Enumeration Date
9 January 2018
Last Update Date
9 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5038296176
Graduation Year
2013 (13 years ago)
PAC ID
4284078528
Group Practice PAC ID
1052508660
Professional Enrollment ID
I20240214004395
Address ID
OR970388840MO317XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

3,358 CHIROPRACTIC in CA

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Provider Addresses for JOON MYUNG KIM (DC)

  • Palo Verde Street, Montclair, San Bernardino County, California, 91763, United States

    MONTCLAIR, CA 917632339

    Phone: (909) 626-7100

    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)

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: 2024-02-14

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
I20240214004395IChiropracticORTBD

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 91763)

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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: 1052508660View full group profile
NameSpecialtyState
C H I R O P R A C T I COR
-OR
C H I R O P R A C T I COR
C H I R O P R A C T I COR

Reviews

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Frequently asked questions

How do I look up JOON MYUNG KIM (DC) by NPI?
Use NPI 1205343548 when you need to reference JOON MYUNG KIM (DC) in forms, claims, or directories.
Is JOON MYUNG KIM (DC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does JOON MYUNG KIM (DC) work in?
You can think of JOON MYUNG KIM (DC) as practicing within Chiropractor. Clinical services aligned with this taxonomy classification.
Where does public data place JOON MYUNG KIM (DC)?
The snapshot lists Montclair, California for JOON MYUNG KIM (DC); download NPPES for the complete set.
How can I contact JOON MYUNG KIM (DC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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