YOUNG JUN KIM FNP
NPI 1417732546
Nurse Practitioner - Family in Glen Burnie, MD
About Young Jun Kim Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
YOUNG JUN KIM FNP (NPI 1417732546) is an individual family provider in Glen Burnie, Maryland, licensed in Maryland (R233728) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).
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
Young Jun Kim Fnp 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 Young Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Pikesville, MD 21208
- Reassigned Medicare billing, Maryland enrollment
- 103 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 2
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 21061 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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GLEN BURNIE, MD 21061
GLEN BURNIE, MD 21061
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 Young Kim's NPI number?
The NPI number for Young Kim is 1417732546. It was assigned to this individual provider in the NPPES registry on August 28, 2023.
Where is Young Kim located?
Young Kim practices at 804 Landmark Dr Ste 118, Glen Burnie, MD 21061. The listed phone number is (410) 863-4899.
What is Young Kim's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Young Kim enrolled in Medicare?
Yes. Young 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 Young Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Young Kim reassigns Medicare benefits to Lifebridge Community Gastroenterology, LLC (Pikesville, MD). 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 Young 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 Young Kim was last updated on August 28, 2023. 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.
# Young Jun Kim, FNP · NPI 1417732546
Family physician in Glen Burnie, Maryland. Individual provider, active in the CMS NPPES registry since August 28, 2023.
## Identity
- **NPI:** 1417732546 (Entity type: Individual)
- **Enumerated:** August 28, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** R233728 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 804 LANDMARK DR STE 118, Glen Burnie, MD 21061-4486
- **Phone:** (410) 863-4899
## 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:** Lifebridge Community Gastroenterology, LLC (NPI 1033558416, Pikesville, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** August 28, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1417732546) · Data from the CMS NPPES public registry.