1. Home
  2. Directory
  3. Virginia
  4. Charlottesville
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

SUSAN JIN KIM MD
NPI 1366019051
Student in an Organized Health Care Education/Training Program in Charlottesville, VA

Active since June 10, 2021PECOS Enrolled
1215 LEE STREET BOX #800719, CHARLOTTESVILLE, VA 22908(434) 924-2150 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Jun 11, 2025, Jun 10, 2021 (2 updates tracked since 2021).

About Susan Jin Kim Md NPPES

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

SUSAN JIN KIM MD (NPI 1366019051) is an individual student in an organized health care education/training program in Charlottesville, Virginia, licensed in Virginia (0101282196) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Springfield.

NPPES Registry Identity

NPI1366019051
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSUSAN JIN KIMCredential: MD
Location Address1215 LEE STREET BOX #800719Charlottesville, VA 22908-0816
Mailing Address1215 Lee Street Box #800719Charlottesville, VA 22908-0816 · (434) 924-2150
Phone(434) 924-2150
Sole ProprietorNo
Enumeration DateJune 10, 2021
Last NPPES UpdateJune 11, 20252 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
✔ NPI 1366019051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in VA · 0101282196
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Location 1

Location 1759 Chestnut StSpringfield, MA 01199-0001 · Phone (413) 794-0000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Jin 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.

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 Susan Kim's NPI number?

The NPI number for Susan Kim is 1366019051. It was assigned to this individual provider in the NPPES registry on June 10, 2021.

Where is Susan Kim located?

Susan Kim practices at 1215 Lee Street Box #800719, Charlottesville, VA 22908. The listed phone number is (434) 924-2150.

What is Susan Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Susan Kim enrolled in Medicare?

Yes. Susan Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Susan Kim was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.