JISOO KIM
NPI 1154819878
Surgery in Greenville, NC

Active since April 27, 2018PECOS EnrolledAccepts Medicare Assignment
517 MOYE BLVD, GREENVILLE, NC 27834(252) 744-2393(252) 744-0013 Get Directions Write a Review

NPPES record last updated: September 24, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 24, 2024, Aug 28, 2023, Apr 27, 2018 (3 updates tracked since 2018).

About Jisoo Kim NPPES

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

JISOO KIM (NPI 1154819878) is an individual surgery provider in Greenville, North Carolina, licensed in North Carolina (2022-02860) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS, is affiliated with Ecu Health Medical Center, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1154819878
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJISOO KIM
Location Address517 MOYE BLVDGreenville, NC 27834-2849
Mailing AddressPo Box 751069Charlotte, NC 28275-1069
Fax(252) 744-0013
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateApril 27, 2018
Last NPPES UpdateSeptember 24, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2024
NPI 1154819878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in NC · 2022-02860
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.

517 MOYE BLVD, Greenville, NC 27834

Accepted 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

Jisoo 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.

PECOS PAC ID2769840529
PECOS Enrollment IDI20230627000322
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.

Hospital Affiliations CMS Care Compare

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

Ecu Health Medical Center

Acute Care Hospitals · Greenville, NC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340040
Location2100 Stantonsburg RdGreenville, NC 27834 · Pitt County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27834 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

Pediatrics
517 MOYE BLVD
GREENVILLE, NC 27834
Pediatrics
517 MOYE BLVD
GREENVILLE, NC 27834
Pediatrics
517 MOYE BLVD
GREENVILLE, NC 27834
Pediatrics
517 MOYE BLVD
GREENVILLE, NC 27834
Pediatrics
517 MOYE BLVD
GREENVILLE, NC 27834
Surgery (Pediatric Surgery)
517 MOYE BLVD
GREENVILLE, NC 27834
Pharmacist
517 MOYE BLVD
GREENVILLE, NC 27834
Pediatrics
517 MOYE BLVD
GREENVILLE, NC 27834

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 Jisoo Kim's NPI number?

The NPI number for Jisoo Kim is 1154819878. It was assigned to this individual provider in the NPPES registry on April 27, 2018.

Where is Jisoo Kim located?

Jisoo Kim practices at 517 Moye Blvd, Greenville, NC 27834. The listed phone number is (252) 744-2393.

What is Jisoo Kim's specialty?

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

Is Jisoo Kim enrolled in Medicare?

Yes. Jisoo 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 Jisoo Kim accept?

Health plans from Blue Cross and Blue Shield of NC list Jisoo 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.

Is Jisoo Kim affiliated with any hospitals?

According to CMS data, Jisoo Kim is affiliated with Ecu Health Medical Center.

When was this NPI record last updated?

The NPPES record for Jisoo Kim was last updated on September 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.