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SU GYM KIM M.D.
NPI 1235418369
Pain Medicine - Interventional Pain Medicine in Providence, RI

Active since August 07, 2011PECOS EnrolledAccepts Medicare Assignment
593 EDDY ST, GEORGE BUILDING, FIRST FLOOR, PROVIDENCE, RI 02903(401) 444-3777(401) 444-7249 Get Directions Write a Review

NPPES record last updated: October 26, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Su Gym Kim M.d. NPPES

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

SU GYM KIM M.D. (NPI 1235418369) is an individual interventional pain medicine provider in Providence, Rhode Island, licensed in Rhode Island (MD15614) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1235418369
Entity TypeIndividualMale
Primary Taxonomy208VP0014X
Provider Legal NameSU GYM KIMCredential: M.D.
Location Address593 EDDY ST, GEORGE BUILDING, FIRST FLOORProvidence, RI 02903-4923
Mailing Address117 Ellenfield St, Suite 101Providence, RI 02905-4513 · (401) 444-6779 · Fax (401) 444-6912
Phone(401) 444-3777
Fax(401) 444-7249
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateAugust 7, 2011
Last NPPES UpdateOctober 26, 2021
NPPES CertifiedOctober 26, 2021
✔ NPI 1235418369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
Licenses✔ Licensed in RI · MD15614✔ Licensed in KY · 46722
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
593 EDDY ST, Providence, RI 02903
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Su Gym Kim M.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 ID5395969943
PECOS Enrollment IDI20190207002162
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Su Gym Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rhode Island Hospital
Same address
Multi-Specialty
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 358 clinicians in this Medicare group
NPI 1154537520 (401) 444-6905
Trinity Health Of New England Provider Network Organization Inc
67 mi
Internal Medicine
114 WOODLAND ST, SAINT FRANCIS MEDICAL GROUP INC.
Hartford, CT 06105
  • Reassigned Medicare billing, Connecticut enrollment
  • 1,186 clinicians in this Medicare group
NPI 1003882812 (860) 714-1325

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
209 services108 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
124 services124 patients
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483
This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
39 services33 patients
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level 64484
This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.
29 services23 patients
Injection of substance into lower spine canal using imaging guidance 62323
This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
13 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02903 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
$134.17 typical visit price
range $58.57 – $177.03
Typical copayment $33.54 (range $14.64 – $44.25)
Most-billed visit code 99204
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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 20

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

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Su Gym Kim's NPI number?

The NPI number for Su Gym Kim is 1235418369. It was assigned to this individual provider in the NPPES registry on August 7, 2011.

Where is Su Gym Kim located?

Su Gym Kim practices at 593 Eddy St George Building, First Floor, Providence, RI 02903. The listed phone number is (401) 444-3777.

What is Su Gym Kim's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Su Gym Kim enrolled in Medicare?

Yes. Su Gym 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.

Which organizations bill Medicare for Su Gym Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Su Gym Kim reassigns Medicare benefits to 2 organizations: Rhode Island Hospital (Providence, RI) and Trinity Health Of New England Provider Network Organization Inc (Hartford, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Su Gym Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Su Gym Kim accept?

Health plans from Anthem Blue Cross and Blue Shield list Su Gym 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 Su Gym Kim was last updated on October 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.