DR. CAROLYN C KIM (OD) – Optometrist, NPI 1467439836

DR. CAROLYN C KIM (OD) is a healthcare provider. based in Glendale, California. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 11404TPA (CA). The NPI Number for DR. CAROLYN C KIM (OD) is 1467439836

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. CAROLYN C KIM (OD)
NPI
1467439836
Phone
(818) 956-1010
Address
607 N CENTRAL AVE
Enumeration Date
28 December 2005
Last Update Date
5 March 2024

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
8182086056
Graduation Year
2000 (26 years ago)
PAC ID
7012983273
Group Practice PAC ID
0446157747
Professional Enrollment ID
I20040908001407
Address ID
CA912031928GL500XXAVEX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,935 OPTOMETRY in CA

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Provider Addresses for DR. CAROLYN C KIM (OD)

  • 607, North Central Avenue, Glendale City Center, North Glendale, Glendale, Los Angeles County, California, 91203, United States

    GLENDALE, CA 91203

    Phone: (818) 956-1010

    Fax: (818) 543-6083

    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: 2004-09-08

PECOS data refreshed: 2026-06-15

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
I20040908001407IOptometryCATBD

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 91203)

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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: 0446157747View full group profile
NameSpecialtyState
U R O L O G YCA
Diagnostic RadiologyCA
-CA
-CA
H E M A T O L O G Y/ O N C O L O G YCA
General SurgeryCA
Certified Registered Nurse Anesthetist (Crna)CA
-CA
Cardiovascular Disease (Cardiology), Internal Medicine, Cardiac ElectrophysiologyCA
Gastroenterology, Internal MedicineMO

Reviews

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Frequently asked questions

Is there an official ID for DR. CAROLYN C KIM (OD) in U.S. healthcare records?
The official identifier for DR. CAROLYN C KIM (OD) is NPI 1467439836.
Would DR. CAROLYN C KIM (OD) appear as active to a payer?
You can treat DR. CAROLYN C KIM (OD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. CAROLYN C KIM (OD)?
DR. CAROLYN C KIM (OD)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. CAROLYN C KIM (OD) associated with Glendale?
Public fields place DR. CAROLYN C KIM (OD) around Glendale, California. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DR. CAROLYN C KIM (OD) is noted as December 28, 2005 where the registry provides it.

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