1. Home
  2. Directory
  3. Michigan
  4. St Clair Shores
  5. Pediatrics
  6. NPI Profile

JAE SUK KIM MD
NPI 1790899755
Pediatrics in St Clair Shores, MI

Active since August 18, 2006PECOS Enrolled
24025 GREATER MACK, SUITE 103, ST CLAIR SHORES, MI 48080(586) 777-8280(586) 777-8688 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jae Suk Kim Md NPPES

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

JAE SUK KIM MD (NPI 1790899755) is an individual pediatrics provider in St Clair Shores, Michigan, licensed in Michigan (4301033045) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790899755
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameJAE SUK KIMCredential: MD
Location Address24025 GREATER MACK, SUITE 103St Clair Shores, MI 48080
Mailing Address24025 Greater Mack, Suite 103St Clair Shores, MI 48080 · (586) 777-8280 · Fax (586) 777-8688
Phone(586) 777-8280
Fax(586) 777-8688
Sole ProprietorNo
Enumeration DateAugust 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1790899755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 4301033045
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.
24025 GREATER MACK, St Clair Shores, MI 48080
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINE49870
Medicaid1947637MI

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 Suk Kim Md 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 48080 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

EASTSIDE PODIATRY PLLC
Podiatrist (Foot & Ankle Surgery)
24025 GREATER MACK, SUITE 101
SAINT CLAIR SHORES, MI 48080
Macomb County (313) 884-7566

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 Kim's NPI number?

The NPI number for Jae Kim is 1790899755. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is Jae Kim located?

Jae Kim practices at 24025 Greater Mack Suite 103, St Clair Shores, MI 48080. The listed phone number is (586) 777-8280.

What is Jae Kim's specialty?

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

Is Jae Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jae Kim was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.