GRACE KIM
NPI 1679991897
Pediatrics in Southlake, TX

Q: What is Grace Kim's NPI number?

The NPI number for Grace Kim is 1679991897. It was assigned to this individual provider in the NPPES registry on April 3, 2014.

Q: What is Grace Kim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Grace Kim was last updated on March 25, 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.

Active since April 03, 2014PECOS Enrolled

925 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092(817) 912-8800 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Grace Kim NPPES

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

GRACE KIM (NPI 1679991897) is an individual pediatrics provider in Southlake, Texas, licensed in Texas (Q9401) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Dallas.

NPPES Registry Identity

NPI1679991897

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameGRACE KIM

Location Address925 E SOUTHLAKE BLVD, SUITE 100Southlake, TX 76092

Mailing Address1935 Medical District DrDallas, TX 75235-7701

Phone(817) 912-8800

Sole ProprietorNo

Enumeration DateApril 3, 2014

Last NPPES UpdateMarch 25, 2022

NPPES CertifiedMarch 25, 2022

✔ NPI 1679991897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TX · Q9401

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

925 E SOUTHLAKE BLVD, Southlake, TX 76092

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Secondary Practice Location 1

Location 11935 Medical District Dr, Graduate Medical EducationDallas, TX 75235-7701 · Phone (214) 456-2735

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace Kim 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76092 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

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

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 3

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

MR. ANDREW REYNA M.D.

Family Medicine

925 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092

Tarrant County (817) 912-8810

DR. AARON ALEXANDER THOMAS MD

Family Medicine

925 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092

Tarrant County (817) 912-8800

DR. KARLA GIOVANA GONZALES DO

Family Medicine

925 E SOUTHLAKE BLVD
SOUTHLAKE, TX 76092

Tarrant County (817) 912-8800

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 Grace Kim's NPI number?

The NPI number for Grace Kim is 1679991897. It was assigned to this individual provider in the NPPES registry on April 3, 2014.

Where is Grace Kim located?

Grace Kim practices at 925 E Southlake Blvd Suite 100, Southlake, TX 76092. The listed phone number is (817) 912-8800.

What is Grace Kim's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Grace Kim enrolled in Medicare?

Yes. Grace Kim is registered in the Medicare PECOS enrollment system.

What insurance does Grace Kim accept?

Health plans from Baylor Scott and White Health Plan and Blue Cross and Blue Shield of Texas list Grace 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.

When was this NPI record last updated?

The NPPES record for Grace Kim was last updated on March 25, 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.