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

Active since March 25, 2017PECOS Enrolled
1638 LYLE DR, SAN JOSE, CA 95129(734) 751-5815 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 22, 2026, Apr 14, 2026, Dec 2, 2025 and 2 more (5 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 San Jose, 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 Address1638 LYLE DRSan Jose, CA 95129-4810
Mailing Address1375 Blossom Hill Rd Ste 49San Jose, CA 95118-3806 · (408) 645-7073 · Fax (669) 500-7491
Phone(734) 751-5815
Sole ProprietorNo
Enumeration DateMarch 25, 2017
Last NPPES UpdateApril 22, 20265 updates tracked since enumeration
NPPES CertifiedApril 22, 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
1638 LYLE DR, San Jose, CA 95129
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Medicare Participation & PECOS CMS

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

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95129 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
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
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.

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 1638 Lyle Dr, San Jose, CA 95129. The listed phone number is (734) 751-5815.

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.

When was this NPI record last updated?

The NPPES record for Jae Youn Kim was last updated on April 22, 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.