MI LA KIM (FNP) – Family Nurse Practitioner, NPI 1295047058
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MI LA KIM (FNP)
PO BOX 10069
SAN BERNARDINO, CA 924230069
Phone: (909) 335-4188
Type: Mailing
33758 YUCAIPA BLVD
YUCAIPA, CA 92399
Phone: (909) 795-9747
Type: Location
2190 Market St
Riverside, CA 92501
Phone: (951) 213-3300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $68.
Total Amount is formed as General ($68) + Research ($0) + Ownership ($0) = $68.
Last reported payment date: 2024-10-29 • Largest payer in this snapshot: ABBVIE INC. ($68).
Total Amount
$68
General + Research + Ownership
Payments
4
Total payment records
General Amount
$68
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $68 |
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: 2015-02-10
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 |
|---|---|---|---|---|
| I20150210000868 | I | Nurse Practitioner | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 40 | 31 | $0 |
Insurance plans in this area (ZIP 92423)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| U R O L O G Y | CA | |
| O P T O M E T R Y | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA |
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