DR. ELISABETH KEUNROK KIM O.D.
NPI 1154469070
Optometrist in Woodbridge, VA

Q: What is Elisabeth Kim's NPI number?

The NPI number for Elisabeth Kim is 1154469070. It was assigned to this individual provider in the NPPES registry on February 2, 2007.

Q: What is Elisabeth Kim's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Elisabeth Kim was last updated on August 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since February 02, 2007PECOS EnrolledAccepts Medicare Assignment

4565 DAISY REID AVE STE 108, WOODBRIDGE, VA 22192(703) 878-8818(703) 878-8819 Get Directions Write a Review

NPPES record last updated: August 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Elisabeth Keunrok Kim O.d. NPPES

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

DR. ELISABETH KEUNROK KIM O.D. (NPI 1154469070) is an individual optometrist in Woodbridge, Virginia, licensed in Virginia (0618001424) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Woodbridge, and is a graduate of Pennsylvania College Of Optometry (1992).

NPPES Registry Identity

NPI1154469070

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. ELISABETH KEUNROK KIMCredential: O.D.

Location Address4565 DAISY REID AVE STE 108Woodbridge, VA 22192-5671

Mailing Address8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442 · (703) 847-8899 · Fax (571) 223-6780

Phone(703) 878-8818

Fax(703) 878-8819

Sole ProprietorNo

Medical School CMSPennsylvania College Of OptometryGraduated 1992

Enumeration DateFebruary 2, 2007

Last NPPES UpdateAugust 27, 2025

NPPES CertifiedAugust 27, 2025

✔ NPI 1154469070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in VA · 0618001424

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

4565 DAISY REID AVE STE 108, Woodbridge, VA 22192

Open in Google Maps ↗

Secondary Practice Location 1

Location 14160 Merchant PlzWoodbridge, VA 22192-5085 · Phone (703) 878-8818 · Fax (703) 878-8819

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Elisabeth Keunrok Kim O.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 ID2264411370

PECOS Enrollment IDI20040726000769

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22192 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

$129.04 typical visit price

range $56.19 – $170.30

Typical copayment $32.26 (range $14.04 – $42.57)

Most-billed visit code 99204

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

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

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

MYEYEDR OPTOMETRY OF VIRGINIA, PLLC

Optometrist

4565 DAISY REID AVE STE 108
WOODBRIDGE, VA 22192

Prince William County (703) 878-8818

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 Elisabeth Kim's NPI number?

The NPI number for Elisabeth Kim is 1154469070. It was assigned to this individual provider in the NPPES registry on February 2, 2007.

Where is Elisabeth Kim located?

Elisabeth Kim practices at 4565 Daisy Reid Ave Ste 108, Woodbridge, VA 22192. The listed phone number is (703) 878-8818.

What is Elisabeth Kim's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Elisabeth Kim enrolled in Medicare?

Yes. Elisabeth 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.

What insurance does Elisabeth Kim accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, BlueCross BlueShield of Tennessee and Providence Health Plan list Elisabeth 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.

When was this NPI record last updated?

The NPPES record for Elisabeth Kim was last updated on August 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.