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KRISTINE KIM DO
NPI 1154017713
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since April 17, 2023PECOS Enrolled
1113 WALLACE ST FL 2, PHILADELPHIA, PA 19123(312) 890-5128 Get Directions Write a Review

NPPES record last updated: May 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kristine Kim Do NPPES

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

KRISTINE KIM DO (NPI 1154017713) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154017713
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKRISTINE KIMCredential: DO
Location Address1113 WALLACE ST FL 2Philadelphia, PA 19123-2509
Mailing Address1919 W Taylor St # Mc663Chicago, IL 60612-7246 · (312) 890-5128
Phone(312) 890-5128
Sole ProprietorNo
Enumeration DateApril 17, 2023
Last NPPES UpdateMay 5, 2023
NPPES CertifiedMay 5, 2023
✔ NPI 1154017713 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.
1113 WALLACE ST FL 2, Philadelphia, PA 19123
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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)

Kristine Kim Do 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.

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 Kristine Kim's NPI number?

The NPI number for Kristine Kim is 1154017713. It was assigned to this individual provider in the NPPES registry on April 17, 2023.

Where is Kristine Kim located?

Kristine Kim practices at 1113 Wallace St Fl 2, Philadelphia, PA 19123. The listed phone number is (312) 890-5128.

What is Kristine 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 Kristine Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kristine Kim was last updated on May 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.