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JACLYN JEONGHOON KIM MD
NPI 1205573870
Family Medicine in Hazelwood, MO

Active since May 16, 2022PECOS EnrolledAccepts Medicare Assignment
755 DUNN RD STE 110, HAZELWOOD, MO 63042(314) 731-1113(314) 731-4020 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 12, 2024, May 16, 2022 (2 updates tracked since 2022).

About Jaclyn Jeonghoon Kim Md NPPES

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

JACLYN JEONGHOON KIM MD (NPI 1205573870) is an individual family medicine provider in Hazelwood, Missouri, licensed in Missouri (2025029327) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS, is affiliated with Mymichigan Medical Center Alma, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1205573870
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameJACLYN JEONGHOON KIMCredential: MD
Location Address755 DUNN RD STE 110Hazelwood, MO 63042-1753
Mailing AddressPo Box 776084Chicago, IL 60677-6084 · (314) 731-1113 · Fax (314) 731-4020
Phone(314) 731-1113
Fax(314) 731-4020
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 16, 2022
Last NPPES UpdateJuly 25, 20252 updates tracked since enumeration
NPPES CertifiedJuly 25, 2025
✔ NPI 1205573870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · 2025029327
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
755 DUNN RD STE 110, Hazelwood, MO 63042
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Other Names 1

Former Name (1)Jaclyn Jeonghoon Marsh Md

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

Jaclyn Jeonghoon Kim Md 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 ID4183003163
PECOS Enrollment IDI20250811003459
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 2

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

Mymichigan Medical Center Alma

Acute Care Hospitals · Alma, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230030
Location300 E Warwick DrAlma, MI 48801 · Gratiot County
Emergency services Birthing friendly

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260020
Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63042 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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 2

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

JONNATHAN RODRIGUEZ MD
Internal Medicine
755 DUNN RD STE 110
HAZELWOOD, MO 63042
St. Louis County (314) 731-4222
MS. JUDY A. NEAL
Nurse Practitioner (Primary Care)
755 DUNN RD STE 110
HAZELWOOD, MO 63042
St. Louis County (314) 731-1113

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 Jaclyn Kim's NPI number?

The NPI number for Jaclyn Kim is 1205573870. It was assigned to this individual provider in the NPPES registry on May 16, 2022. The provider is also known as Jaclyn Jeonghoon Marsh MD.

Where is Jaclyn Kim located?

Jaclyn Kim practices at 755 Dunn Rd Ste 110, Hazelwood, MO 63042. The listed phone number is (314) 731-1113.

What is Jaclyn Kim's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jaclyn Kim enrolled in Medicare?

Yes. Jaclyn 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.

Is Jaclyn Kim affiliated with any hospitals?

According to CMS data, Jaclyn Kim is affiliated with Mymichigan Medical Center Alma and Mercy Hospital St Louis.

When was this NPI record last updated?

The NPPES record for Jaclyn Kim was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.