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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JAE YOUN KIM FNP-C
NPI 1720519283
Nurse Practitioner - Family in Fremont, CA

Active since March 25, 2017PECOS Enrolled
2682 MOWRY AVE, FREMONT, CA 94538(510) 248-8201 Get Directions Write a Review

NPPES record last updated: October 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2026, Apr 22, 2026, Apr 14, 2026 and 3 more (6 updates tracked since 2017).

About Jae Youn Kim Fnp-c NPPES

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

JAE YOUN KIM FNP-C (NPI 1720519283) is an individual family provider in Fremont, California, licensed in California (95034282) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720519283
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJAE YOUN KIMCredential: FNP-C
Location Address2682 MOWRY AVEFremont, CA 94538-1619
Mailing Address2682 Monwry AveFremont, CA 94538 · (510) 248-8201
Phone(510) 248-8201
Sole ProprietorNo
Enumeration DateMarch 25, 2017
Last NPPES UpdateOctober 9, 20266 updates tracked since enumeration
NPPES CertifiedOctober 6, 2026
✔ NPI 1720519283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in CA · 95034282✔ Licensed in GA · RN213977
2682 MOWRY AVE, Fremont, CA 94538
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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 (PECOS)

Jae Youn Kim Fnp-c 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.

Medicare Billing Reassignments

3

Medicare enrollment records show Jae Youn Kim reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Southeast Permanente Medical Group
2,116 mi
Internal Medicine
3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305
  • Reassigned Medicare billing, Georgia enrollment
  • 1,389 clinicians in this Medicare group
NPI 1245266956 (404) 364-3821
The Emory Clinic Inc
2,120 mi
Internal Medicine
1365 CLIFTON RD NE
Atlanta, GA 30322
  • Reassigned Medicare billing, Georgia enrollment
  • 4,840 clinicians in this Medicare group
NPI 1396798229 (404) 778-2144
Alpha Internal Medicine, LLC
2,120 mi
Internal Medicine
745 GLYNN ST S
Fayetteville, GA 30214
  • Reassigned Medicare billing, Georgia enrollment
  • 18 clinicians in this Medicare group
NPI 1083622849 (770) 719-5490

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 94538 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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

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

WASHINGTON TOWNSHIP MEDICAL FOUNDATION
Clinic/Center (Urgent Care)
2682 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 248-1000

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 Jae Youn Kim's NPI number?

The NPI number for Jae Youn Kim is 1720519283. It was assigned to this individual provider in the NPPES registry on March 25, 2017.

Where is Jae Youn Kim located?

Jae Youn Kim practices at 2682 Mowry Ave, Fremont, CA 94538. The listed phone number is (510) 248-8201.

What is Jae Youn Kim's specialty?

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

Is Jae Youn Kim enrolled in Medicare?

Yes. Jae Youn Kim is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jae Youn Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jae Youn Kim reassigns Medicare benefits to 3 organizations: The Southeast Permanente Medical Group (Atlanta, GA), The Emory Clinic Inc (Atlanta, GA) and Alpha Internal Medicine, LLC (Fayetteville, GA). Each 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 Jae Youn 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 Jae Youn Kim was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days 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.