CHARLES CHOL BAE KIM (MD) – Adult Medicine Physician, NPI 1225564818

CHARLES CHOL BAE KIM (MD) is a healthcare provider. based in Tustin, California. specializing in GENERAL SURGERY, FAMILY PRACTICE, FAMILY PRACTICE, INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 54481 (AZ). The NPI Number for CHARLES CHOL BAE KIM (MD) is 1225564818

Main info

Male
Sole Proprietor
45 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES CHOL BAE KIM (MD)
NPI
1225564818
Phone
(714) 831-1112
Address
14642 NEWPORT AVE STE 105
Enumeration Date
3 May 2017
Last Update Date
13 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2134463046
Graduation Year
1981 (45 years ago)
PAC ID
8921374232
Professional Enrollment ID
I20171031002424
Address ID
CA900062521LO3071XBLVD401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:9State licenses:3Digital endpointsOther names

3,317 GENERAL SURGERY in CA

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Provider Addresses for CHARLES CHOL BAE KIM (MD)

  • Newport Avenue, Cowan Heights, North Tustin, Orange County, California, 92780, United States

    TUSTIN, CA 927806058

    Phone: (714) 831-1112

    Fax: (714) 486-2309

    Type: Mailing

  • 1200 W MOHAVE RD

    PARKER, AZ 853446349

    Phone: (928) 669-7380

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-04-05 • Largest payer in this snapshot: Harrow Eye, LLC ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-05

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Harrow Eye, LLC$20
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: 2020-12-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20171031002424IFamily PracticeCATBD
I20201207002894IGeneral SurgeryAZTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97610Therapy procedure using ultrasound2,120292$0
11046Removal of muscle and/or tissue, each additional 20.0 sq cm or less1,183121$0
11043Removal of muscle and/or tissue, 20.0 sq cm or less1,097288$0
11042Removal of skin and tissue, 20.0 sq cm or less482164$0
11045Removal of skin and tissue, each additional 20.0 sq cm or less44743$0
View full utilization report →

Insurance plans in this area (ZIP 92780)

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Reviews

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Frequently asked questions

How do I look up CHARLES CHOL BAE KIM (MD) by NPI?
Use NPI 1225564818 when you need to reference CHARLES CHOL BAE KIM (MD) in forms, claims, or directories.
Is CHARLES CHOL BAE KIM (MD)'s NPI currently valid?
The extract we use shows CHARLES CHOL BAE KIM (MD) as active.
Can you summarize CHARLES CHOL BAE KIM (MD)'s specialty in plain language?
Clinically, the directory lists CHARLES CHOL BAE KIM (MD) with Adult Medicine Physician. Clinical services aligned with this taxonomy classification.
Does CHARLES CHOL BAE KIM (MD) practice in California?
You will see Tustin, California on file for CHARLES CHOL BAE KIM (MD) alongside any extra practice locations.
Is CHARLES CHOL BAE KIM (MD) a real provider?
This page reflects official NPPES data for NPI 1225564818. Always confirm identity and privileges with the practice and licensing boards.

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