NOAH EUISUB KIM
NPI 1790489102
Physician Assistant in Libertyville, IL

Q: What is Noah Kim's NPI number?

The NPI number for Noah Kim is 1790489102. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Q: What is Noah Kim's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Noah Kim was last updated on June 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since March 29, 2023PECOS EnrolledAccepts Medicare Assignment

890 GARFIELD AVE STE 206, LIBERTYVILLE, IL 60048(847) 816-7495(847) 816-7497 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 26, 2025, Jan 5, 2024, Mar 29, 2023 (3 updates tracked since 2023).

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About Noah Euisub Kim NPPES

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

NOAH EUISUB KIM (NPI 1790489102) is an individual physician assistant in Libertyville, Illinois, licensed in Illinois (085009901) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Advocate Condell Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1790489102

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameNOAH EUISUB KIM

Location Address890 GARFIELD AVE STE 206Libertyville, IL 60048-3100

Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900

Phone(847) 816-7495

Fax(847) 816-7497

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 29, 2023

Last NPPES UpdateJune 26, 20253 updates tracked since enumeration

NPPES CertifiedJune 26, 2025

✔ NPI 1790489102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085009901

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

890 GARFIELD AVE STE 206, Libertyville, IL 60048

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Secondary Practice Locations 2

Location 13502 Green Bay Rd Apt 203North Chicago, IL 60064-3615 · Phone (224) 432-4823

Location 24309 W Medical Center Dr Ste B202McHenry, IL 60050-8417 · Phone (815) 455-2752 · Fax (815) 455-2789

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Noah Euisub 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 ID2264887272

PECOS Enrollment IDI20231011002808

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

69 services50 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

19 services19 patients

Repair of groin hernia using an endoscope 49650

This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Advocate Condell Medical Center

Acute Care Hospitals · Libertyville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140202

Location801 S Milwaukee AveLibertyville, IL 60048 · Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60048 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

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

Most-billed visit code 99213

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 5

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

ALI AMRO M.D.

Surgery