JANNIE RENE KIM APRN
NPI 1417670290
Nurse Practitioner - Primary Care in Rockville, MD
About Jannie Rene Kim Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JANNIE RENE KIM APRN (NPI 1417670290) is an individual primary care provider in Rockville, Maryland, licensed in Maryland (R255370) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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
Jannie Rene Kim Aprn 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 Reassignments
2Medicare enrollment records show Jannie Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Rockville, MD 20854
- Reassigned Medicare billing, District of Columbia and Maryland enrollments
- 168 clinicians in this Medicare group
Rockville, MD 20850
- Reassigned Medicare billing, District of Columbia enrollment
- 145 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.
Areas of Expertise CMS Part B claims 9
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 20854 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Jannie Kim's NPI number?
The NPI number for Jannie Kim is 1417670290. It was assigned to this individual provider in the NPPES registry on September 26, 2022. The provider is also known as Jannie Rene Suratos.
Where is Jannie Kim located?
Jannie Kim practices at 7955 Tuckerman Ln, Rockville, MD 20854. The listed phone number is (866) 389-2727.
What is Jannie Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Jannie Kim enrolled in Medicare?
Yes. Jannie 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 organizations bill Medicare for Jannie Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jannie Kim reassigns Medicare benefits to 2 organizations: Minuteclinic LLC (Rockville, MD) and Comprehensive Primary Care And Associates LLC (Rockville, MD). Each 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 Jannie 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 Jannie Kim was last updated on October 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jannie Rene Kim, APRN · NPI 1417670290
Primary Care physician in Rockville, Maryland. Individual provider, active in the CMS NPPES registry since September 26, 2022.
## Identity
- **NPI:** 1417670290 (Entity type: Individual)
- **Enumerated:** September 26, 2022
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** R255370 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 7955 TUCKERMAN LN, Rockville, MD 20854-3243
- **Phone:** (866) 389-2727
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Minuteclinic LLC (NPI 1134191836, Rockville, MD); Comprehensive Primary Care And Associates LLC (NPI 1831492586, Rockville, MD) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** October 27, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1417670290) · Data from the CMS NPPES public registry.