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SPENCER ELIOT KIM
NPI 1104762731
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since April 27, 2026PECOS Enrolled
3400 SPRUCE ST, PHILADELPHIA, PA 19104(781) 733-3986 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Spencer Eliot Kim NPPES

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

SPENCER ELIOT KIM (NPI 1104762731) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104762731
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSPENCER ELIOT KIM
Location Address3400 SPRUCE STPhiladelphia, PA 19104-4238
Mailing Address3400 Spruce StPhiladelphia, PA 19104-4238
Phone(781) 733-3986
Sole ProprietorNo
Enumeration DateApril 27, 2026
NPPES CertifiedApril 27, 2026
✔ NPI 1104762731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3400 SPRUCE ST, Philadelphia, PA 19104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer Eliot Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

ELIZABETH FOGLIA MD
Pediatrics
3400 SPRUCE ST, 8 RAVDIN
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3228
JOEL M STEIN MD
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3005
PRISCILLA NELSON M.D.
Anesthesiology
3400 SPRUCE ST, 6 DULLES
PHILADELPHIA, PA 19104
Philadelphia County (215) 349-8310
DR. JASON THOMAS ACKRIVO MD
Internal Medicine (Pulmonary Disease)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 614-0871
JEAN-PHILIPPE RICHARD DMD
Student in an Organized Health Care Education/Training Program
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-6176
LEAH M LOPEZ PA-C
Physician Assistant (Medical)
3400 SPRUCE ST, 4 SILVERSTEIN
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-7870
MONIQUE LORRAINE ROBERTS SALAHUB
Anesthesiology (Critical Care Medicine)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-4000
JOANIE M GARRATT MD
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3000

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 Spencer Kim's NPI number?

The NPI number for Spencer Kim is 1104762731. It was assigned to this individual provider in the NPPES registry on April 27, 2026.

Where is Spencer Kim located?

Spencer Kim practices at 3400 Spruce St, Philadelphia, PA 19104. The listed phone number is (781) 733-3986.

What is Spencer Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Spencer Kim enrolled in Medicare?

Yes. Spencer Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Spencer Kim was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.