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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JESSICA KIM NP
NPI 1245941046
Nurse Practitioner - Adult Health in Woodbury, NY

Active since December 12, 2022PECOS EnrolledAccepts Medicare Assignment
95 FROEHLICH FARM BLVD, WOODBURY, NY 11797(516) 302-8532(516) 838-6182 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 5, 2026, Dec 12, 2022 (2 updates tracked since 2022).

About Jessica Kim Np NPPES

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

JESSICA KIM NP (NPI 1245941046) is an individual adult health provider in Woodbury, New York, licensed in New York (311107) and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS, is affiliated with Good Samaritan Hospital Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1245941046
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameJESSICA KIMCredential: NP
Location Address95 FROEHLICH FARM BLVDWoodbury, NY 11797-2930
Mailing Address95 Froehlich Farm BlvdWoodbury, NY 11797-2930 · (516) 302-8532 · Fax (516) 838-6182
Phone(516) 302-8532
Fax(516) 838-6182
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 12, 2022
Last NPPES UpdateAugust 5, 20262 updates tracked since enumeration
NPPES CertifiedAugust 5, 2026
✔ NPI 1245941046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · 311107
95 FROEHLICH FARM BLVD, Woodbury, NY 11797
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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

Jessica Kim Np 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 ID1759813512
PECOS Enrollment IDI20241017002386
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.

Areas of Expertise CMS Part B claims

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.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Good Samaritan Hospital Medical Center

Acute Care Hospitals · West Islip, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number330286
Location1000 Montauk HighwayWest Islip, NY 11795 · Suffolk County
Emergency services Birthing friendly

Chsli St Joseph Hospital

Acute Care Hospitals · Bethpage, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330332
Location4295 Hempstead TurnpikeBethpage, NY 11714 · Nassau County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11797 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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.

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 Jessica Kim's NPI number?

The NPI number for Jessica Kim is 1245941046. It was assigned to this individual provider in the NPPES registry on December 12, 2022.

Where is Jessica Kim located?

Jessica Kim practices at 95 Froehlich Farm Blvd, Woodbury, NY 11797. The listed phone number is (516) 302-8532.

What is Jessica Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Jessica Kim enrolled in Medicare?

Yes. Jessica 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 Jessica Kim affiliated with any hospitals?

According to CMS data, Jessica Kim is affiliated with Good Samaritan Hospital Medical Center and Chsli St Joseph Hospital.

When was this NPI record last updated?

The NPPES record for Jessica Kim was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days 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.