DANIEL KIM (P.A.) – Physician Assistant, NPI 1275813370
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DANIEL KIM (P.A.)
400 N PEPPER AVE 205
COLTON, CA 923241801
Phone: (909) 580-6353
Fax: (909) 580-6369
Type: Mailing
1505 W. 17TH ST
SAN BERNARDINO, CA 924112661
Phone: (909) 887-6494
Fax: (909) 887-6043
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 77 Open Payments records for all available years, with a total value of $3,136.
Total Amount is formed as General ($3,136) + Research ($0) + Ownership ($0) = $3,136.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Lilly USA, LLC ($516).
Total Amount
$3,136
General + Research + Ownership
Payments
77
Total payment records
General Amount
$3,136
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $516 |
| E.R. Squibb & Sons, L.L.C. | $400 |
| ABBVIE INC. | $337 |
| Arcutis Biotherapeutics, Inc. | $283 |
| Sun Pharmaceutical Industries Inc. | $264 |
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: 2012-01-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120125000230 | I | Physician Assistant | CA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17004 | Destruction of precancer skin growth, 15 or more growths | 12 | 11 | $0 |
Insurance plans in this area (ZIP 92324)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| - | CA | |
| Dermatology, General Surgery | CA | |
| Physician Assistant | CA | |
| - | CA | |
| - | CA | |
| Physician Assistant | CA | |
| D E R M A T O L O G Y | MA | |
| Nurse Practitioner | CA | |
| Physician Assistant | CA |
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