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JIN KIM
NPI 1316564404
Counselor - Mental Health in South Ozone Park, NY

Active since July 06, 2020PECOS EnrolledAccepts Medicare Assignment
10819 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420(718) 327-7163 Get Directions Write a Review

NPPES record last updated: July 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jin Kim NPPES

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

JIN KIM (NPI 1316564404) is an individual mental health provider in South Ozone Park, New York and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1316564404
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJIN KIM
Location Address10819 ROCKAWAY BLVDSouth Ozone Park, NY 11420-1034
Mailing Address8935 155th Ave Apt 2mHoward Beach, NY 11414-1521
Phone(718) 327-7163
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateJuly 6, 2020
NPPES CertifiedJuly 6, 2020
✔ NPI 1316564404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
10819 ROCKAWAY BLVD, South Ozone Park, NY 11420
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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 and accepts Medicare assignment

Jin Kim 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 ID9335586049
PECOS Enrollment IDI20240318000989
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 Jin Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New Horizon Counseling Center Inc
Same address
Mental Health (Including Community Mental Health Center)
10819 ROCKAWAY BLVD
South Ozone Park, NY 11420
  • Reassigned Medicare billing, New York enrollment
  • 187 clinicians in this Medicare group
NPI 1366430563 (718) 845-2620

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

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.

AMANDA KHAN
Counselor (Addiction (Substance Use Disorder))
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2621
MICHAEL GROOVER JR. LMSW
Social Worker
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2620
TANIA REINO
Case Management
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2620
MS. NATASHA DEZONIE LMSW
Counselor
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2620
TOMAS KISS-FARENGO
Student in an Organized Health Care Education/Training Program
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2620
MICHAELA THOMAS
Social Worker
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2621
CRAIG LOPRESTI
Social Worker (Clinical)
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2620
NEW HORIZON COUNSELING CENTER INC
Community/Behavioral Health
10819 ROCKAWAY BLVD
SOUTH OZONE PARK, NY 11420
Queens County (718) 845-2620

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 Jin Kim's NPI number?

The NPI number for Jin Kim is 1316564404. It was assigned to this individual provider in the NPPES registry on July 6, 2020.

Where is Jin Kim located?

Jin Kim practices at 10819 Rockaway Blvd, South Ozone Park, NY 11420. The listed phone number is (718) 327-7163.

What is Jin Kim's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jin Kim enrolled in Medicare?

Yes. Jin 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 organization bills Medicare for Jin Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jin Kim reassigns Medicare benefits to New Horizon Counseling Center Inc (South Ozone Park, NY). 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 Jin 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 Jin Kim was last updated on July 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.