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SOON JA KIM MD PA
NPI 1669796710
Family Medicine - Adult Medicine in Elkridge, MD

Active since March 18, 2010
5808 MAIN ST, ELKRIDGE, MD 21075(410) 796-7730(410) 379-1537 Get Directions Write a Review

NPPES record last updated: April 21, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Soon Ja Kim Md Pa NPPES

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

SOON JA KIM MD PA (NPI 1669796710) is a healthcare organization registered as an adult medicine in Elkridge, Maryland and active in the NPI registry since March 2010. The organization lists Soon Ja Kim, President, as its authorized official.

NPPES Registry Identity

NPI1669796710
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameSOON JA KIM MD PA
Location Address5808 MAIN STElkridge, MD 21075-5105
Mailing Address5808 Main StElkridge, MD 21075-5105 · (410) 796-7730 · Fax (410) 379-1537
Phone(410) 796-7730
Fax(410) 379-1537
Organization SubpartNo
Authorized OfficialSoon Ja KimPresident · (410) 796-7730
Enumeration DateMarch 18, 2010
Last NPPES UpdateApril 21, 2010
✔ NPI 1669796710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
5808 MAIN ST, Elkridge, MD 21075
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Other Identifiers 4

Medicaid794391100MD
Other010003063MD · Medicare Railroad
Medicare UPIND71548MD
Medicare PIN4933MD

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)

Soon Ja Kim Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Soon Ja Kim MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Soon Kim, MD
Family Practice
NPI 1023095643
5808 MAIN ST
Elkridge, MD 21075
(410) 796-7730
✔ 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.

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 Ja Kim MD PA's NPI number?

The NPI number for Soon Ja Kim MD PA is 1669796710. It was assigned to this organization in the NPPES registry on March 18, 2010.

Where is Soon Ja Kim MD PA located?

Soon Ja Kim MD PA is located at 5808 Main St, Elkridge, MD 21075. The listed phone number is (410) 796-7730.

What is Soon Ja Kim MD PA's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Soon Ja Kim MD PA enrolled in Medicare?

Yes. Soon Ja Kim MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Soon Ja Kim MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Soon Ja Kim MD PA. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Soon Ja Kim MD PA was last updated on April 21, 2010. 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.