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MOON JOO KIM MD
NPI 1255825469
Pathology - Anatomic Pathology & Clinical Pathology in Pocatello, ID

Active since June 20, 2018PECOS Enrolled
2431 ANDREW ST, POCATELLO, ID 83201(281) 798-2210 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Moon Joo Kim Md NPPES

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

MOON JOO KIM MD (NPI 1255825469) is an individual anatomic pathology & clinical pathology provider in Pocatello, Idaho, licensed in Idaho (M-17400) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255825469
Entity TypeIndividualFemale
Primary Taxonomy207ZP0102X
Provider Legal NameMOON JOO KIMCredential: MD
Location Address2431 ANDREW STPocatello, ID 83201-8000
Mailing Address2431 Andrew StPocatello, ID 83201-8000
Phone(281) 798-2210
Sole ProprietorNo
Enumeration DateJune 20, 2018
Last NPPES UpdateMay 22, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1255825469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in ID · M-17400
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
2431 ANDREW ST, Pocatello, ID 83201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moon Joo Kim Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Moon Joo Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bmh Inc.
2.3 mi
Nurse Practitioner
1553 E CENTER ST
Pocatello, ID 83201
  • Reassigned Medicare billing, Idaho enrollment
  • 159 clinicians in this Medicare group
NPI 1104332048 (208) 233-9355

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83201 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
$121.27 typical visit price
range $52.44 – $160.17
Typical copayment $30.31 (range $13.11 – $40.04)
Most-billed visit code 99204
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.

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 Moon Joo Kim's NPI number?

The NPI number for Moon Joo Kim is 1255825469. It was assigned to this individual provider in the NPPES registry on June 20, 2018.

Where is Moon Joo Kim located?

Moon Joo Kim practices at 2431 Andrew St, Pocatello, ID 83201. The listed phone number is (281) 798-2210.

What is Moon Joo Kim's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Moon Joo Kim enrolled in Medicare?

Yes. Moon Joo Kim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Moon Joo Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Moon Joo Kim reassigns Medicare benefits to Bmh Inc. (Pocatello, ID). The 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 Moon Joo Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Moon Joo Kim was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.