ANDREW JEE SOO KIM MD
NPI 1053670133
Family Medicine in Clarkston, GA
About Andrew Jee Soo Kim Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW JEE SOO KIM MD (NPI 1053670133) is an individual family medicine provider in Clarkston, Georgia, licensed in Georgia (078379) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of State University Of New York Downstate Medical Center (2012).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Andrew Jee Soo Kim Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Andrew Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clarkston, GA 30021
- Reassigned Medicare billing, Georgia enrollment
- 13 clinicians in this Medicare group
Lagrange, GA 30240
- Reassigned Medicare billing, Georgia enrollment
- 1,506 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 6
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Emory Decatur Hospital
Acute Care Hospitals · Decatur, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CLARKSTON, GA 30021
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Kim's NPI number?
The NPI number for Andrew Kim is 1053670133. It was assigned to this individual provider in the NPPES registry on May 10, 2012.
Where is Andrew Kim located?
Andrew Kim practices at 980 Rowland St Ste 4190, Clarkston, GA 30021. The listed phone number is (470) 799-0044.
What is Andrew Kim's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Andrew Kim enrolled in Medicare?
Yes. Andrew Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Andrew Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Kim reassigns Medicare benefits to 2 organizations: Ethne Health, Inc (Clarkston, GA) and Emory Specialty Associates, LLC (Lagrange, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Andrew Kim accept?
Health plans from Ambetter Health and Oscar Health list Andrew Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Andrew Kim affiliated with any hospitals?
According to CMS data, Andrew Kim is affiliated with Emory Decatur Hospital.
When was this NPI record last updated?
The NPPES record for Andrew Kim was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Andrew Jee Soo Kim, MD · NPI 1053670133
Family Medicine physician in Clarkston, Georgia. Individual provider, active in the CMS NPPES registry since May 10, 2012.
## Identity
- **NPI:** 1053670133 (Entity type: Individual)
- **Enumerated:** May 10, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 078379 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 980 ROWLAND ST STE 4190, Clarkston, GA 30021-2203
- **Phone:** (470) 799-0044 · **Fax:** (470) 799-0045
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Ethne Health, Inc (NPI 1538646054, Clarkston, GA); Emory Specialty Associates, LLC (NPI 1407864168, Lagrange, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** State University Of New York Downstate Medical Center, class of 2012
## Record status
- **NPPES last updated:** October 7, 2026
- **Other identifiers:** Medicaid 003216356A (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1053670133) · Data from the CMS NPPES public registry.