SAN KIM
NPI 1912684978
Student in an Organized Health Care Education/Training Program in Boston, MA
About San Kim NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAN KIM (NPI 1912684978) is an individual student in an organized health care education/training program in Boston, Massachusetts, licensed in Massachusetts (3020128) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
San Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
BOSTON, MA 02114
BOSTON, MA 02114
BOSTON, MA 02114
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 San Kim's NPI number?
The NPI number for San Kim is 1912684978. It was assigned to this individual provider in the NPPES registry on June 30, 2023.
Where is San Kim located?
San Kim practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 726-8707.
What is San Kim's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is San Kim enrolled in Medicare?
Yes. San Kim is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for San Kim was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days 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.
# San Kim · NPI 1912684978
Student in an Organized Health Care Education/Training Program provider in Boston, Massachusetts. Individual provider, active in the CMS NPPES registry since June 30, 2023.
## Identity
- **NPI:** 1912684978 (Entity type: Individual)
- **Enumerated:** June 30, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** 3020128 (Massachusetts)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 55 FRUIT ST, Boston, MA 02114-2696
- **Phone:** (617) 726-8707
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1912684978) · Data from the CMS NPPES public registry.