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JU WON KIM
NPI 1699561159
Nurse Practitioner - Family in Essex, CT

Active since April 18, 2025PECOS EnrolledAccepts Medicare Assignment
10 WILDWOOD MEDICAL CTR, ESSEX, CT 06426(860) 767-0145 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ju Won Kim NPPES

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

JU WON KIM (NPI 1699561159) is an individual family provider in Essex, Connecticut, licensed in Connecticut (15136) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1699561159
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJU WON KIM
Location Address10 WILDWOOD MEDICAL CTREssex, CT 06426-1154
Mailing Address10 Wildwood Medical CtrEssex, CT 06426-1154
Phone(860) 767-0145
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateApril 18, 2025
Last NPPES UpdateJune 1, 2026
NPPES CertifiedJune 1, 2026
✔ NPI 1699561159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CT · 15136
Also ListedRegistered NurseTaxonomy 163W00000X · License 196260 (CT)
10 WILDWOOD MEDICAL CTR, Essex, CT 06426
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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

Ju Won 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 ID4183112741
PECOS Enrollment IDI20251024001082
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 Ju Won Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Prohealth Physicians PC
41 mi
Family Medicine
3 FARM GLEN BLVD, PROHEALTH PHYSICIANS
Farmington, CT 06032
  • Reassigned Medicare billing, Connecticut enrollment
  • 496 clinicians in this Medicare group
NPI 1720194053 (860) 284-5200

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 06426 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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 6

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

DR. ALAN MICHAEL SPAGNOLA M.D.
Internal Medicine
10 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Lower Connecticut River Valley Planning Region (860) 767-0145
DR. MICHAEL DAVID BALDWIN DO
Family Medicine
10 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Lower Connecticut River Valley Planning Region (860) 767-0145
DRS. BALDWIN, HORNBAKE AND SPAGNOLA PC
Internal Medicine
10 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Lower Connecticut River Valley Planning Region (860) 767-0145
RODNEY HORNBAKE MD, PC
Internal Medicine
10 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Lower Connecticut River Valley Planning Region (860) 767-0145
ALAN M SPAGNOLA, MD, PC
Internal Medicine (Rheumatology)
10 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Lower Connecticut River Valley Planning Region (860) 767-0145
EARL RODNEY HORNBAKE III MD
Internal Medicine
10 WILDWOOD MEDICAL CTR
ESSEX, CT 06426
Lower Connecticut River Valley Planning Region (860) 767-0145

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 Ju Won Kim's NPI number?

The NPI number for Ju Won Kim is 1699561159. It was assigned to this individual provider in the NPPES registry on April 18, 2025.

Where is Ju Won Kim located?

Ju Won Kim practices at 10 Wildwood Medical Ctr, Essex, CT 06426. The listed phone number is (860) 767-0145.

What is Ju Won Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ju Won Kim enrolled in Medicare?

Yes. Ju Won 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 Ju Won Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ju Won Kim reassigns Medicare benefits to Prohealth Physicians PC (Farmington, CT). 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 Ju Won 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 Ju Won Kim was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.