SOO Y KIM M.D.
NPI 1295763423
Pediatrics in Highland, CA

Q: What is Soo Kim's NPI number?

The NPI number for Soo Kim is 1295763423. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Q: What is Soo Kim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Soo Kim was last updated on December 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since June 28, 2006PECOS Enrolled

7000 BOULDER AVE, HIGHLAND, CA 92346(909) 862-1191 Get Directions Write a Review

NPPES record last updated: December 27, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 27, 2025, Jan 26, 2022 (2 updates tracked since 2022).

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About Soo Y Kim M.d. NPPES

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

SOO Y KIM M.D. (NPI 1295763423) is an individual pediatrics provider in Highland, California, licensed in California (A61217) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Moreno Valley.

NPPES Registry Identity

NPI1295763423

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameSOO Y KIMCredential: M.D.

Location Address7000 BOULDER AVEHighland, CA 92346-3348

Mailing AddressPo Box 35380Las Vegas, NV 89133-5380 · (702) 579-3203

Phone(909) 862-1191

Sole ProprietorNo

Enumeration DateJune 28, 2006

Last NPPES UpdateDecember 27, 20252 updates tracked since enumeration

NPPES CertifiedDecember 27, 2025

✔ NPI 1295763423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · A61217

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

7000 BOULDER AVE, Highland, CA 92346

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Secondary Practice Location 1

Location 111401 Heacock St, Suite 330Moreno Valley, CA 92557-7908 · Phone (951) 247-8697 · Fax (951) 243-0513

Other Identifiers 1

Medicaid00A612170CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Soo Y Kim M.d. 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 Reassignments

Medicare enrollment records show Soo Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Faculty Physicians And Surgeons Of Llusm

1.4 mi

Pediatrics

7223 CHURCH ST, SUITE C-1
Highland, CA 92346

Reassigned Medicare billing, California enrollment
2,584 clinicians in this Medicare group

NPI 1689624991 (909) 425-3936

Beaver Medical Group P C

5.7 mi

Family Medicine

2 WEST FERN AVENUE
Redlands, CA 92373

Reassigned Medicare billing, California enrollment
635 clinicians in this Medicare group

NPI 1649503319 (909) 793-3311

Healthcare Partners Affiliates Medical Group

45 mi

Addiction Medicine

14591 NEWPORT AVE
Tustin, CA 92780

Reassigned Medicare billing, California enrollment
2,052 clinicians in this Medicare group

NPI 1891981502 (714) 442-4864

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 92346 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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.

RAYMOND SEDGH M.D.

Family Medicine