JI MIN KIM
NPI 1073960399
Nurse Practitioner - Gerontology in Chicago, IL
About Ji Min Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JI MIN KIM (NPI 1073960399) is an individual gerontology provider in Chicago, Illinois, licensed in Illinois (209014282) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Evanston, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2015).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
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
Ji Min Kim 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
4Medicare enrollment records show Ji Min Kim reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Chicago, IL 60605
- Reassigned Medicare billing, Illinois enrollment
- Medicare enrollment name: Rush University Medical Group
- 2,169 clinicians in this Medicare group
Oak Park, IL 60304
- Reassigned Medicare billing, Illinois enrollment
- 124 clinicians in this Medicare group
Evanston, IL 60201
- Reassigned Medicare billing, Illinois enrollment
- 4,841 clinicians in this Medicare group
Carol Stream, IL 60122
- Reassigned Medicare billing, Illinois enrollment
- 4,817 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60611 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.
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.
CHICAGO, IL 60611
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 Ji Min Kim's NPI number?
The NPI number for Ji Min Kim is 1073960399. It was assigned to this individual provider in the NPPES registry on May 17, 2016.
Where is Ji Min Kim located?
Ji Min Kim practices at 259 E Erie St, Chicago, IL 60611. The listed phone number is (312) 695-4517.
What is Ji Min Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Ji Min Kim enrolled in Medicare?
Yes. Ji Min 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 Ji Min Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ji Min Kim reassigns Medicare benefits to 4 organizations: Rush University Medical Center (Chicago, IL), Rush Oak Park ER Physicians Group (Oak Park, IL), Endeavor Health Medical Group (Evanston, IL) and Northwestern Medical Faculty Foundation (Carol Stream, IL). 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 Ji Min Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ji Min Kim was last updated on November 2, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Ji Min Kim · NPI 1073960399
Gerontology physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since May 17, 2016.
## Identity
- **NPI:** 1073960399 (Entity type: Individual)
- **Enumerated:** May 17, 2016
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 209014282 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 259 E ERIE ST, Chicago, IL 60611-2987
- **Phone:** (312) 695-4517
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): Rush University Medical Center (NPI 1689165540, Chicago, IL); Rush Oak Park ER Physicians Group (NPI 1447260880, Oak Park, IL); Endeavor Health Medical Group (NPI 1497701882, Evanston, IL); Northwestern Medical Faculty Foundation (NPI 1346235314, Carol Stream, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Illinois College Of Med, class of 2015
## Record status
- **NPPES last updated:** November 2, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1073960399) · Data from the CMS NPPES public registry.