MARK KIM (MD) – Gastroenterology Physician, NPI 1679645154

MARK KIM (MD) is a healthcare provider. based in Baldwin park, California. specializing in INTERNAL MEDICINE, GASTROENTEROLOGY. They hold the professional credentials MD. They hold a License No. G72178 (CA). The NPI Number for MARK KIM (MD) is 1679645154

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
MARK KIM (MD)
NPI
1679645154
Phone
(626) 851-1011
Address
1011 BALDWIN PARK BLVD
Enumeration Date
14 November 2006
Last Update Date
30 November 2021

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Secondary Phone
8776080044
Graduation Year
1990 (36 years ago)
PAC ID
6204960800
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20100818000712
Address ID
CA917066807IR12761AVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

21,511 INTERNAL MEDICINE in CA

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Provider Addresses for MARK KIM (MD)

  • Kaiser Permanente Baldwin Park Medical Center, 1011, Baldwin Park Boulevard, Baldwin Park, Los Angeles County, California, 91706, United States

    BALDWIN PARK, CA 917065806

    Phone: (626) 851-1011

    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: 2010-08-18

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
I20100818000712IInternal MedicineCATBD

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 91706)

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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: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARK KIM (MD)?
MARK KIM (MD) — NPI 1679645154 — is the standard way to identify this listing.
Does CMS list MARK KIM (MD) as active?
Yes — MARK KIM (MD) is active in the NPI listing used on this page.
What is MARK KIM (MD)'s primary classification?
Gastroenterology Physician is the headline specialty for MARK KIM (MD) here. Clinical services aligned with this taxonomy classification.
What address line appears for MARK KIM (MD)?
MARK KIM (MD)'s geographic hint is Baldwin Park, California in our summary view.
Why does MARK KIM (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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