LISA JIYOUNG KIM FNP-C
NPI 1548754385
Nurse Practitioner - Family in Boston, MA

Q: What is Lisa Kim's NPI number?

The NPI number for Lisa Kim is 1548754385. It was assigned to this individual provider in the NPPES registry on June 15, 2018.

Q: What is Lisa Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Kim was last updated on February 17, 2022. 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.

Active since June 15, 2018PECOS Enrolled

830 HARRISON AVE, MOAKLEY, 3RD FLOOR, BOSTON, MA 02118(617) 638-6428(617) 638-5756 Get Directions Write a Review

NPPES record last updated: February 17, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 17, 2022, Aug 27, 2020, Jul 16, 2018 and 1 more (4 updates tracked since 2018).

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About Lisa Jiyoung Kim Fnp-c NPPES

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

LISA JIYOUNG KIM FNP-C (NPI 1548754385) is an individual family provider in Boston, Massachusetts, licensed in Massachusetts (RN2278996) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548754385

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA JIYOUNG KIMCredential: FNP-C

Location Address830 HARRISON AVE, MOAKLEY, 3RD FLOORBoston, MA 02118

Mailing Address801 Albany Street, Floor GroundBoston, MA 02119

Phone(617) 638-6428

Fax(617) 638-5756

Sole ProprietorNo

Enumeration DateJune 15, 2018

Last NPPES UpdateFebruary 17, 20224 updates tracked since enumeration

NPPES CertifiedFebruary 17, 2022

✔ NPI 1548754385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MA · RN2278996

830 HARRISON AVE, Boston, MA 02118

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Other Identifiers 1

Medicaid110146618AMA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Jiyoung Kim Fnp-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. MAUREEN T KAVANAH M.D.

Surgery (Surgical Oncology)

830 HARRISON AVE, MOAKLEY SUITE 1200
BOSTON, MA 02118

Suffolk County (617) 638-8655

MR. DAVID M. TAUSEVICH CRNA, APRN, MS, CCRN

Nurse Anesthetist, Certified Registered

830 HARRISON AVE, SUITE 3500
BOSTON, MA 02118

Suffolk County (617) 638-8776

KARIMOT A MAKINDE FNP-C

Nurse Practitioner (Family)

830 HARRISON AVE, SUITE 1200, MOAKLEY BUILDING
BOSTON, MA 02118

Suffolk County (617) 414-7990

DR. HIROKO KUNITAKE MD

Colon & Rectal Surgery

830 HARRISON AVE, SUITE 2100
BOSTON, MA 02118

Suffolk County (617) 414-8054

DR. NAOMI KO M.D.

Internal Medicine (Medical Oncology)

830 HARRISON AVE, MOAKLEY, 3RD FLOOR
BOSTON, MA 02118

Suffolk County (617) 638-6428

DR. ANDREEA M NEGROIU M.D.

Internal Medicine (Medical Oncology)

830 HARRISON AVE, MOAKLEY, 3RD FLOOR
BOSTON, MA 02118

Suffolk County (617) 638-6428

DR. DUC BA PHAN AUD

Audiologist

830 HARRISON AVE
BOSTON, MA 02118

Suffolk County (617) 638-8124

CHRISTINE ENGLE

Nurse Practitioner (Adult Health)

830 HARRISON AVE, MOAKLEY 3RD FLOOR
BOSTON, MA 02118

Suffolk County (617) 638-6428

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 Lisa Kim's NPI number?

The NPI number for Lisa Kim is 1548754385. It was assigned to this individual provider in the NPPES registry on June 15, 2018.

Where is Lisa Kim located?

Lisa Kim practices at 830 Harrison Ave Moakley, 3rd Floor, Boston, MA 02118. The listed phone number is (617) 638-6428.

What is Lisa Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Lisa Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Lisa Kim was last updated on February 17, 2022. 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.