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SUSAN EUNJI KIM LCSW
NPI 1750857751
Counselor - Mental Health in Riverside, CA

Active since October 17, 2018PECOS EnrolledAccepts Medicare Assignment
11870 PIERCE ST STE 200, RIVERSIDE, CA 92505(951) 248-4000 Get Directions Write a Review

NPPES record last updated: April 18, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 18, 2024, Jul 10, 2023, Aug 2, 2021 and 1 more (4 updates tracked since 2018).

About Susan Eunji Kim Lcsw NPPES

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

SUSAN EUNJI KIM LCSW (NPI 1750857751) is an individual mental health provider in Riverside, California, licensed in California (114780) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1750857751
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSUSAN EUNJI KIMCredential: LCSW
Location Address11870 PIERCE ST STE 200Riverside, CA 92505-5186
Mailing Address11870 Pierce St Ste 200Riverside, CA 92505-5186 · (951) 248-4000
Phone(951) 248-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateOctober 17, 2018
Last NPPES UpdateApril 18, 20244 updates tracked since enumeration
NPPES CertifiedApril 18, 2024
✔ NPI 1750857751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in CA · 114780✔ Licensed in CA · 83283
11870 PIERCE ST STE 200, Riverside, CA 92505
Open in Google Maps ↗

Secondary Practice Locations 2

Location 113800 Heacock St Ste D111Moreno Valley, CA 92553-3340 · Phone (951) 653-1800
Location 2520 S Lafayette Park Place 3rd FloorLos Angeles, CA 90057-5400 · Phone (213) 252-2100

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

Susan Eunji Kim Lcsw 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 ID3274071691
PECOS Enrollment IDI20240816001838
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 Susan Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
1.4 mi
Health Maintenance Organization
10800 MAGNOLIA AVE
Riverside, CA 92505
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group
NPI 1316979834 (866) 984-7483

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

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

QUIANA JOHNSON
Psychiatry & Neurology (Psychiatry)
11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
Riverside County (951) 248-4000
ALICIA MEREDITH LCSW
Social Worker (Clinical)
11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
Riverside County (833) 579-4848
JOHANNA PAOLA PAZ
Marriage & Family Therapist
11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
Riverside County (951) 248-4000
LESLIE ROMERO-GALLEGOS
Social Worker (Clinical)
11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
Riverside County (951) 248-4000
STEPHANIE CRISTERNA-CASILLAS
Counselor (Mental Health)
11870 PIERCE ST STE 200
RIVERSIDE, CA 92505
Riverside County (951) 248-4000

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 Susan Kim's NPI number?

The NPI number for Susan Kim is 1750857751. It was assigned to this individual provider in the NPPES registry on October 17, 2018.

Where is Susan Kim located?

Susan Kim practices at 11870 Pierce St Ste 200, Riverside, CA 92505. The listed phone number is (951) 248-4000.

What is Susan Kim's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Susan Kim enrolled in Medicare?

Yes. Susan 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 Susan Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Kim reassigns Medicare benefits to Southern California Permanente Medical Group (Riverside, CA). 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 Susan 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 Susan Kim was last updated on April 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.