1. Home
  2. Directory
  3. Idaho
  4. Boise
  5. Psychologist
  6. NPI Profile

JEAN M. KIM PHD
NPI 1205214194
Psychologist - Clinical in Boise, ID

Active since May 11, 2015PECOS Enrolled
500 W. FORT ST, CRH, 2ND FLOOR, BOISE, ID 83702(208) 422-1018 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 1, 2024, Oct 17, 2019, Feb 6, 2019 (3 updates tracked since 2019).

About Jean M. Kim Phd NPPES

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

JEAN M. KIM PHD (NPI 1205214194) is an individual clinical provider in Boise, Idaho, licensed in Washington (PY60847665) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1205214194
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameJEAN M. KIMCredential: PHD
Location Address500 W. FORT ST, CRH, 2ND FLOORBoise, ID 83702-4501
Mailing Address1660 S. Columbian Way, S-116-mhcSeattle, WA 98108-1597
Phone(208) 422-1018
Sole ProprietorNo
Enumeration DateMay 11, 2015
Last NPPES UpdateOctober 1, 20243 updates tracked since enumeration
NPPES CertifiedOctober 1, 2024
✔ NPI 1205214194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in WA · PY60847665
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologistTaxonomy 103T00000X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
500 W. FORT ST, Boise, ID 83702
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13620 McClintock AveLos Angeles, CA 90089-0105 · Phone (213) 740-1600
Location 21660 S. Columbian Way, S-116-MHCSeattle, WA 98108-1597 · Phone (989) 430-9847

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jean M. Kim Phd 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83702 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
$160.17 typical visit price
range $52.44 – $160.17
Typical copayment $40.04 (range $13.11 – $40.04)
Most-billed visit code 99205
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
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 7

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

SARAH HAYDEN PA
Physician Assistant
500 W. FORT ST, # 111
BOISE, ID 83702
Ada County (208) 422-1000
STEVEN J FONKEN MD
Internal Medicine (Cardiovascular Disease)
500 W. FORT ST, # 111
BOISE, ID 83702
Ada County (208) 422-1000
MRS. ANNIE C FIFE NP
Nurse Practitioner (Women's Health)
500 W. FORT ST
BOISE, ID 83702
Ada County (208) 422-7760
BRIAN E. COTHERN MD
Family Medicine
500 W. FORT ST, CALDWELL CBOC
BOISE, ID 83702
Ada County (208) 422-1000
ANGELA HOFFMAN RADIMER PA
Physician Assistant (Medical)
500 W. FORT ST, # 111
BOISE, ID 83702
Ada County (208) 422-1000
MELISSA MAE HAGMAN MD
Internal Medicine (Hospice and Palliative Medicine)
500 W. FORT ST, # 111R
BOISE, ID 83702
Ada County (208) 422-1000
RICK WRIGHT D.O.
Emergency Medicine
500 W. FORT ST, EMERGENCY DEPT.
BOISE, ID 83702
Ada County (208) 422-1000

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 Jean Kim's NPI number?

The NPI number for Jean Kim is 1205214194. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Where is Jean Kim located?

Jean Kim practices at 500 W. Fort St Crh, 2nd Floor, Boise, ID 83702. The listed phone number is (208) 422-1018.

What is Jean Kim's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jean Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jean Kim was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.