SOO CHAN KIM
NPI 1609752666
Physical Therapist in Reston, VA

Active since August 14, 2025Accepts Medicare Assignment
11490 COMMERCE PARK DR STE 412, RESTON, VA 20191(703) 564-4636 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 8, 2025, Aug 14, 2025 (2 updates tracked since 2025).

About Soo Chan Kim NPPES

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

SOO CHAN KIM (NPI 1609752666) is an individual physical therapist in Reston, Virginia, licensed in Virginia (2305217403) and active in the NPI registry since August 2025. He is a graduate of Other (2025).

NPPES Registry Identity

NPI1609752666
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameSOO CHAN KIM
Location Address11490 COMMERCE PARK DR STE 412Reston, VA 20191-1590
Mailing Address11490 Commerce Park Dr Ste 412Reston, VA 20191-1590 · (703) 860-3200
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 14, 2025
Last NPPES UpdateOctober 8, 20252 updates tracked since enumeration
NPPES CertifiedOctober 8, 2025
✔ NPI 1609752666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in VA · 2305217403
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
11490 COMMERCE PARK DR STE 412, Reston, VA 20191

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

Soo Chan Kim 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.

PECOS PAC ID3476059585
PECOS Enrollment IDI20250929002035

Medicare Billing Reassignments

2

Medicare enrollment records show Soo Chan Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orthopedic
13135 LEE JACKSON MEMORIAL HWY STE 320
Fairfax, VA 22033
  • Reassigned Medicare billing, District of Columbia enrollment
  • 8 clinicians in this Medicare group
Physical Therapist
4701 SPOTSYLVANIA PKWY, SUITE 106
Fredericksburg, VA 22407
  • Reassigned Medicare billing, District of Columbia enrollment
  • 8 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20191 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Soo Chan Kim's NPI number?

The NPI number for Soo Chan Kim is 1609752666. It was assigned to this individual provider in the NPPES registry on August 14, 2025.

Where is Soo Chan Kim located?

Soo Chan Kim practices at 11490 Commerce Park Dr Ste 412, Reston, VA 20191. The listed phone number is (703) 564-4636.

What is Soo Chan Kim's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Soo Chan Kim enrolled in Medicare?

Yes. Soo Chan 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 Soo Chan Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Soo Chan Kim reassigns Medicare benefits to 2 organizations: Orthocare Physical Therapy Center, LLC (Fairfax, VA) and Fusion Physiotherapy Associates LLC (Fredericksburg, VA). 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 Soo Chan 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 Soo Chan Kim was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.