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FAIRFAX FAMILY MEDICINE CENTER
NPI 1609812510
Family Medicine in Fairfax, VA

Active since June 20, 2006CLIA 49D1015687 · Microscopy
10801 MAIN ST, SUITE 700, FAIRFAX, VA 22030(703) 591-4100(703) 591-5380 Get Directions Write a Review

NPPES record last updated: October 26, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Fairfax Family Medicine Center NPPES

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

FAIRFAX FAMILY MEDICINE CENTER (NPI 1609812510) is a healthcare organization registered as a family medicine in Fairfax, Virginia and active in the NPI registry since June 2006. The organization holds a CLIA Microscopy certificate valid through August 11, 2027 and lists Michael D Kim, President, as its authorized official.

NPPES Registry Identity

NPI1609812510
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMICHAEL D KIM MD PC
Location Address10801 MAIN ST, SUITE 700Fairfax, VA 22030-4745
Mailing Address10801 Main St, Suite 700Fairfax, VA 22030-4745 · (703) 591-4100 · Fax (703) 591-5380
Phone(703) 591-4100
Fax(703) 591-5380
Organization SubpartNo
Authorized OfficialMichael D KimPresident · (703) 591-4100
Enumeration DateJune 20, 2006
Last NPPES UpdateOctober 26, 2009
✔ NPI 1609812510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in VA · 0101233609
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
10801 MAIN ST, Fairfax, VA 22030
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Other Names 1

Doing Business AsFairfax Family Medicine Center

Other Identifiers 9

Other2110066Mamsi Ppo
Medicaid010002834VA
OtherH9840001Carefirst
Other465828Anthem Bcbs
Other625622Ncppo
Medicare ID-Type UnspecifiedG01209
Other7741476Aetna Ppo
Other3314356Aetna Hmo
Medicare UPING713868

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fairfax Family Medicine Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Fairfax Family Medicine Center, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Juliana Choi, NP
Nurse Practitioner
NPI 1336178516
10801 MAIN STREET SUITE 700
Fairfax, VA 22030
(703) 591-4100
✔ PECOS✔ Accepts MedicareSame address
Injung Kim
Nurse Practitioner
NPI 1487095311
10801 MAIN ST STE 700
Fairfax, VA 22030
(703) 591-4100
✔ PECOSSame address
Michael Kim, MD
Family Practice
NPI 1144291097
10801 MAIN ST SUITE 700
Fairfax, VA 22030
(703) 591-4100
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D1015687

Fairfax Family Medicine Center · Fairfax, VA
Active · expires Aug 11, 2027
CLIA Number49D1015687
Laboratory TypePhysician Office
Certificate Effective DateAugust 12, 2025
Certificate Expiration DateAugust 11, 2027
Laboratory DirectorMichael D. Kim
Laboratory Phone(703) 591-4100
Laboratory LocationFairfax Family Medicine Center10801 Main Street - Suite 700, Fairfax, VA 22030
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Michael D Kim MD PC's NPI number?

The NPI number for Michael D Kim MD PC is 1609812510. It was assigned to this organization in the NPPES registry on June 20, 2006. The provider is doing business as Fairfax Family Medicine Center.

Where is Michael D Kim MD PC located?

Michael D Kim MD PC is located at 10801 Main St Suite 700, Fairfax, VA 22030. The listed phone number is (703) 591-4100.

What is Michael D Kim MD PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael D Kim MD PC enrolled in Medicare?

Yes. Michael D Kim MD PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Michael D Kim MD PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Michael D Kim MD PC, in Family Practice and Nurse Practitioner. A 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 the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Michael D Kim MD PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 49D1015687) is associated with this NPI, valid through August 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Michael D Kim MD PC was last updated on October 26, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.