SOOHYUN KIM
NPI 1336804418
Counselor - Mental Health in Commack, NY
About Soohyun Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOOHYUN KIM (NPI 1336804418) is an individual mental health provider in Commack, New York, licensed in New York (P111995) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
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
Soohyun 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.
Medicare Billing Reassignment
Medicare enrollment records show Soohyun Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Westbury, NY 11590
- Reassigned Medicare billing, New York enrollment
- 17 clinicians in this Medicare group
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.
COMMACK, NY 11725
COMMACK, NY 11725
COMMACK, NY 11725
COMMACK, NY 11725
COMMACK, NY 11725
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 Soohyun Kim's NPI number?
The NPI number for Soohyun Kim is 1336804418. It was assigned to this individual provider in the NPPES registry on November 3, 2021.
Where is Soohyun Kim located?
Soohyun Kim practices at 2171 Jericho Tpke, Commack, NY 11725. The listed phone number is (516) 817-6002.
What is Soohyun Kim's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Soohyun Kim enrolled in Medicare?
Yes. Soohyun 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 Soohyun Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Soohyun Kim reassigns Medicare benefits to Sr Medical Services PLLC (Westbury, 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 Soohyun 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 Soohyun Kim was last updated on November 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Soohyun Kim · NPI 1336804418
Mental Health provider in Commack, New York. Individual provider, active in the CMS NPPES registry since November 3, 2021.
## Identity
- **NPI:** 1336804418 (Entity type: Individual)
- **Enumerated:** November 3, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** P111995 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 2171 JERICHO TPKE, Commack, NY 11725-2937
- **Phone:** (516) 817-6002
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Sr Medical Services PLLC (NPI 1063119543, Westbury, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** November 3, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1336804418) · Data from the CMS NPPES public registry.