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DR. SUNGJIN IM PHD
NPI 1275222127
Psychologist - Clinical in Lindenhurst, NY

Active since May 05, 2023PECOS Enrolled
888 SURF ST, LINDENHURST, NY 11757(270) 681-0773 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 18, 2026, May 5, 2023 (2 updates tracked since 2023).

About Dr. Sungjin Im Phd NPPES

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

DR. SUNGJIN IM PHD (NPI 1275222127) is an individual clinical provider in Lindenhurst, New York, licensed in Kentucky (276794) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1275222127
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. SUNGJIN IMCredential: PHD
Location Address888 SURF STLindenhurst, NY 11757-6238
Mailing Address100 Duffy Ave Ste 510Hicksville, NY 11801-3636 · (270) 681-0773
Phone(270) 681-0773
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateMay 5, 2023
Last NPPES UpdateMarch 18, 20262 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1275222127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in KY · 276794✔ Licensed in NY · 024766
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.
888 SURF ST, Lindenhurst, NY 11757
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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 (PECOS)

Dr. Sungjin Im Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971024704
PECOS Enrollment IDI20260429001907
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 Sungjin Im reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health Specialty Group PA
441 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Kentucky enrollment
  • 47 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

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 11757 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
$203.53 typical visit price
range $67.40 – $203.53
Typical copayment $50.88 (range $16.85 – $50.88)
Most-billed visit code 99205
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 Sungjin Im's NPI number?

The NPI number for Sungjin Im is 1275222127. It was assigned to this individual provider in the NPPES registry on May 5, 2023.

Where is Sungjin Im located?

Sungjin Im practices at 888 Surf St, Lindenhurst, NY 11757. The listed phone number is (270) 681-0773.

What is Sungjin Im's specialty?

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

Is Sungjin Im enrolled in Medicare?

Yes. Sungjin Im is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sungjin Im's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sungjin Im reassigns Medicare benefits to Mental Health Specialty Group PA (Durham, NC). 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 Sungjin Im's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sungjin Im accept?

Health plans from Anthem Blue Cross and Blue Shield list Sungjin Im 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 Sungjin Im was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.