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MRS. SOON KIM M.D.
NPI 1649381153
Surgery in Gardnerville, NV

Active since August 31, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1516 VIRGINIA RANCH RD, GARDNERVILLE, NV 89410(775) 783-3020(775) 783-3021 Get Directions Write a Review

NPPES record last updated: January 21, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Soon Kim M.d. NPPES

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

MRS. SOON KIM M.D. (NPI 1649381153) is an individual surgery provider in Gardnerville, Nevada, licensed in Nevada (10696) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Mesa View Regional Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1992).

NPPES Registry Identity

NPI1649381153
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameMRS. SOON KIMCredential: M.D.
Location Address1516 VIRGINIA RANCH RDGardnerville, NV 89410-5794
Mailing Address1516 Virginia Ranch RdGardnerville, NV 89410-5794 · (775) 783-3020 · Fax (775) 783-3021
Phone(775) 783-3020
Fax(775) 783-3021
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1992
Enumeration DateAugust 31, 2006
Last NPPES UpdateJanuary 21, 2013
✔ NPI 1649381153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in NV · 10696
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1516 VIRGINIA RANCH RD, Gardnerville, NV 89410
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Other Identifiers 5

Medicaid100502384NV
Medicare UPINH60385NV
Medicare PINV105788NV
Medicare ID-Type UnspecifiedVH29001601
Medicare PINGJ523ZNV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross and Blue Shield of Texas.Insurance ›

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

Mrs. Soon Kim M.d. 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 ID6800871179
PECOS Enrollment IDI20040621001553
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 Soon Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mesquite Clinic Management Company LLC
339 mi
Internal Medicine
1301 BERTHA HOWE AVE STE 1
Mesquite, NV 89027
  • Reassigned Medicare billing, Nevada enrollment
  • 19 clinicians in this Medicare group
NPI 1548800501 (702) 346-0800

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 10

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
72 services68 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
57 services56 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
55 services51 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
52 services52 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
45 services45 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
42 services42 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mesa View Regional Hospital

Critical Access Hospitals · Mesquite, NV
1/5 CMS rating
OwnershipProprietary
CMS Certification Number291307
Location1299 Bertha Howe AvenueMesquite, NV 89027 · Clark County
Emergency services

St. George Regional Hospital

Acute Care Hospitals · St George, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460021
Location1380 East Medical Center DriveSt George, UT 84790 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89410 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
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASEY DANELLE DRISCOLL
Nurse Practitioner (Family)
1516 VIRGINIA RANCH RD
GARDNERVILLE, NV 89410
Douglas County (775) 783-4823
JOSEPH T POLLINO PA-C
Physician Assistant
1516 VIRGINIA RANCH RD
GARDNERVILLE, NV 89410
Douglas County (775) 783-4823
LISA VICTORIA PUALUAN
Nurse Practitioner
1516 VIRGINIA RANCH RD
GARDNERVILLE, NV 89410
Douglas County (775) 783-4823
CELESTE MARIE CALLINAN PA-C
Physician Assistant
1516 VIRGINIA RANCH RD, SUITE 201
GARDNERVILLE, NV 89410
Douglas County (775) 783-3020
HANNAH LIANE GULISANO
Nurse Practitioner (Gerontology)
1516 VIRGINIA RANCH RD
GARDNERVILLE, NV 89410
Douglas County (775) 783-4823
JASMINE HAAS APRN
Nurse Practitioner (Family)
1516 VIRGINIA RANCH RD
GARDNERVILLE, NV 89410
Douglas County (775) 783-4823
ROGER ROGALSKI MD CHTD
Orthopaedic Surgery
1516 VIRGINIA RANCH RD, BLDG. A, SUITE 101
GARDNERVILLE, NV 89410
Douglas County (775) 841-9991

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 Soon Kim's NPI number?

The NPI number for Soon Kim is 1649381153. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Soon Kim located?

Soon Kim practices at 1516 Virginia Ranch Rd, Gardnerville, NV 89410. The listed phone number is (775) 783-3020.

What is Soon Kim's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Soon Kim enrolled in Medicare?

Yes. Soon 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 Soon Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Soon Kim reassigns Medicare benefits to Mesquite Clinic Management Company LLC (Mesquite, NV). 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 Soon Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Soon Kim accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health and Blue Cross and Blue Shield of Texas list Soon Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Soon Kim affiliated with any hospitals?

According to CMS data, Soon Kim is affiliated with Mesa View Regional Hospital and St. George Regional Hospital.

When was this NPI record last updated?

The NPPES record for Soon Kim was last updated on January 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.