MINA KIM
NPI 1801559133
Psychologist in Fairfax, VA
About Mina Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MINA KIM (NPI 1801559133) is an individual psychologist in Fairfax, Virginia and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2018).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mina Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mina Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Falls Church, VA 22042
- Reassigned Medicare billing, District of Columbia enrollment
- 2,618 clinicians in this Medicare group
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 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAIRFAX, VA 22031
FAIRFAX, VA 22031
FAIRFAX, VA 22031
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 Mina Kim's NPI number?
The NPI number for Mina Kim is 1801559133. It was assigned to this individual provider in the NPPES registry on October 13, 2021.
Where is Mina Kim located?
Mina Kim practices at 8280 Willow Oaks Corporate Dr, Fairfax, VA 22031. The listed phone number is (571) 472-4300.
What is Mina Kim's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Mina Kim enrolled in Medicare?
Yes. Mina Kim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mina Kim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mina Kim reassigns Medicare benefits to Inova Health Care Services (Falls Church, VA). 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 Mina 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 Mina Kim was last updated on May 29, 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.