1. Home
  2. Directory
  3. New Mexico
  4. Shiprock
  5. Pediatrics
  6. NPI Profile

LYDIA SOO-HYUN KIM
NPI 1780973396
Pediatrics in Shiprock, NM

Active since April 04, 2011PECOS Enrolled
US HWY 491 NORTH, SHIPROCK, NM 87420(505) 368-6001(505) 368-7011 Get Directions Write a Review

NPPES record last updated: September 17, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lydia Soo-hyun Kim NPPES

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

LYDIA SOO-HYUN KIM (NPI 1780973396) is an individual pediatrics provider in Shiprock, New Mexico, licensed in California (A125333) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780973396
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameLYDIA SOO-HYUN KIM
Location AddressUS HWY 491 NORTHShiprock, NM 87420
Mailing AddressPo Box 160Shiprock, NM 87420-0160 · (505) 368-6001 · Fax (505) 368-7011
Phone(505) 368-6001
Fax(505) 368-7011
Sole ProprietorNo
Enumeration DateApril 4, 2011
Last NPPES UpdateSeptember 17, 2015
✔ NPI 1780973396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A125333
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.
US HWY 491 NORTH, Shiprock, NM 87420
Open in Google Maps ↗

Other Identifiers 1

Medicare OSCAR/certification320059

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lydia Soo-hyun 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Lydia Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dhhs, Phs, Naihs, Shiprock Hospital
15 mi
General Acute Care Hospital
US HIGHWAY 491 NORTH
Shiprock, NM 87420
  • Reassigned Medicare billing, Texas enrollment
  • 572 clinicians in this Medicare group
NPI 1780639971 (505) 368-6401
County Of Los Angeles
535 mi
Clinic/Center
16921 E AVENUE O STE G
Palmdale, CA 93591
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1366453045 (California)
  • 1,939 clinicians in this Medicare group
NPI 1720090616 (661) 945-8444

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 87420 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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 20

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

ZELDA GAIL GARCIA LCSW
Social Worker (Clinical)
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-6001
DR. MATTHEW S SPIVA DPM
Podiatrist
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-6001
CYNTHIA L. DUNDER RN
Registered Nurse
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-6401
JULIE ANN WALKER PHARMD, BCPS
Pharmacist
US HWY 491 NORTH, NORTHERN NAVAJO MEDICAL CENTER PHARMACY DEPARTMENT
SHIPROCK, NM 87420
San Juan County (505) 386-7266
MS. DONIELLE DAWN BIGMAN FNP-BC
Nurse Practitioner (Family)
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-6001
AIMEE E MCMULLIN MD
Family Medicine
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-6001
FLOYD P BOND MD
Obstetrics & Gynecology
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-6401
SANDRA BEIRNE MD
Pediatrics
US HWY 491 NORTH
SHIPROCK, NM 87420
San Juan County (505) 368-7060

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 Lydia Kim's NPI number?

The NPI number for Lydia Kim is 1780973396. It was assigned to this individual provider in the NPPES registry on April 4, 2011.

Where is Lydia Kim located?

Lydia Kim practices at Us Hwy 491 North, Shiprock, NM 87420. The listed phone number is (505) 368-6001.

What is Lydia Kim's specialty?

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

Is Lydia Kim enrolled in Medicare?

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

Which organizations bill Medicare for Lydia Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lydia Kim reassigns Medicare benefits to 2 organizations: Dhhs, Phs, Naihs, Shiprock Hospital (Shiprock, NM) and County Of Los Angeles (Palmdale, CA). 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 Lydia 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 Lydia Kim was last updated on September 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.