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

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: October 25, 2026.

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

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
Open in Google Maps ↗

Other Identifiers 1

Medicaid110146618AMA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dana-Farber Cancer Institute, Inc.
1.8 mi
General Acute Care Hospital
450 BROOKLINE AVE
Boston, MA 02215
  • Reassigned Medicare billing, Massachusetts enrollment
  • 1,026 clinicians in this Medicare group
NPI 1851333686 (617) 632-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organization bills Medicare for Lisa Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Kim reassigns Medicare benefits to Dana-Farber Cancer Institute, Inc. (Boston, MA). 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 Lisa 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 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.