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JENNIFER KIM M.D.
NPI 1053798264
Surgery in Shreveport, LA

Active since April 27, 2015PECOS EnrolledAccepts Medicare Assignment
1501 KINGS HWY, SURGERY, SHREVEPORT, LA 71103(318) 675-2655 Get Directions Write a Review

NPPES record last updated: September 9, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jennifer Kim M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER KIM M.D. (NPI 1053798264) is an individual surgery provider in Shreveport, Louisiana, licensed in Illinois (036153868) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of University Of Oklahoma College Of Medicine (2015).

NPPES Registry Identity

NPI1053798264
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameJENNIFER KIMCredential: M.D.
Location Address1501 KINGS HWY, SURGERYShreveport, LA 71103-4228
Mailing Address8600 N State Route 91Peoria, IL 61615-9541 · (309) 691-4005 · Fax (309) 691-6144
Phone(318) 675-2655
Sole ProprietorNo
Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 2015
Enumeration DateApril 27, 2015
Last NPPES UpdateSeptember 9, 2020
NPPES CertifiedSeptember 9, 2020
✔ NPI 1053798264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036153868
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1501 KINGS HWY, Shreveport, LA 71103
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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

Jennifer Kim M.d. 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.

PECOS PAC ID2860798915
PECOS Enrollment IDI20200929000213
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Osf Multi-Specialty Group
616 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1922445527 (309) 683-5050

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 8

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
74 services52 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
58 services37 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
41 services37 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
30 services30 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
23 services23 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services22 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140064
Location3333 North SeminaryGalesburg, IL 61401 · Knox County
Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Osf Saint Elizabeth Mdl Ctr

Acute Care Hospitals · Ottawa, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140110
Location1100 E Norris DriveOttawa, IL 61350 · La Salle County
Emergency services Birthing friendly

Osf Saint Luke Medical Center

Critical Access Hospitals · Kewanee, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141325
Location1051 West South StreetKewanee, IL 61443 · Henry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.60 typical visit price
range $53.43 – $164.73
Typical copayment $20.90 (range $13.35 – $41.18)
Most-billed visit code 99203
Established Patient
$67.06 typical visit price
range $16.64 – $133.62
Typical copayment $16.76 (range $4.16 – $33.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HS LOUISIANA, LLC
General Practice
1501 KINGS HWY, SUITE 5-303
SHREVEPORT, LA 71103
Caddo Parish (904) 834-2679
MUNIRA DAWITH MD
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY, PSYCHIATRY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-6619
SEFI AHMED JAWADI
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0505
LUKE MUIZNIEKS
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-1574
KRISTIN BEMBENICK
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-5300
CHRISTIAN SCOTT BAKER MD
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 675-5053
BRYCE MILLER DO
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0434
NEERAJ PAVAN REDDY TELUGU
Student in an Organized Health Care Education/Training Program
1501 KINGS HWY
SHREVEPORT, LA 71103
Caddo Parish (318) 626-0434

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 Jennifer Kim's NPI number?

The NPI number for Jennifer Kim is 1053798264. It was assigned to this individual provider in the NPPES registry on April 27, 2015.

Where is Jennifer Kim located?

Jennifer Kim practices at 1501 Kings Hwy Surgery, Shreveport, LA 71103. The listed phone number is (318) 675-2655.

What is Jennifer Kim's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Jennifer Kim enrolled in Medicare?

Yes. Jennifer 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 organization bills Medicare for Jennifer Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Kim reassigns Medicare benefits to Osf Multi-Specialty Group (Peoria, IL). The 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 Jennifer Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jennifer Kim affiliated with any hospitals?

According to CMS data, Jennifer Kim is affiliated with St Mary Medical Center, Saint Francis Medical Center, Osf Saint Elizabeth Mdl Ctr and Osf Saint Luke Medical Center.

When was this NPI record last updated?

The NPPES record for Jennifer Kim was last updated on September 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.