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JEAN KIM MD
NPI 1942095112
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 10, 2025PECOS Enrolled
4201 SAINT ANTOINE ST, DETROIT, MI 48201(313) 745-3000 Get Directions Write a Review

NPPES record last updated: April 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jean Kim Md NPPES

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

JEAN KIM MD (NPI 1942095112) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942095112
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJEAN KIMCredential: MD
Location Address4201 SAINT ANTOINE STDetroit, MI 48201-2153
Mailing Address4201 Saint Antoine St # 9cDetroit, MI 48201-2153 · (313) 745-5146 · Fax (313) 966-0880
Phone(313) 745-3000
Sole ProprietorNo
Enumeration DateApril 10, 2025
NPPES CertifiedApril 10, 2025
✔ NPI 1942095112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4201 SAINT ANTOINE ST, Detroit, MI 48201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jean 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.

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.

DR. ZOHA NIZAMI
Pediatrics (Pediatric Emergency Medicine)
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146
DR. PUJA LAROIA DO
Anesthesiology
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146
ELIZABETH ANNE RANELLA CRNA
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (952) 442-9770
GERARD LANCASTER MD
Orthopaedic Surgery
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-3000
SARAH ZHANG
Emergency Medicine
4201 SAINT ANTOINE ST, UHC-6G
DETROIT, MI 48201
Wayne County (313) 993-2529
DAVID BURKHOLDER
Student in an Organized Health Care Education/Training Program
4201 SAINT ANTOINE ST, 6G UHC
DETROIT, MI 48201
Wayne County (313) 993-2530
DR. DANIEL RAY CAVAZOS MD
Orthopaedic Surgery
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-3000
WAHAJUDDIN MOHAMMAD DO
Student in an Organized Health Care Education/Training Program
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146

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 Jean Kim's NPI number?

The NPI number for Jean Kim is 1942095112. It was assigned to this individual provider in the NPPES registry on April 10, 2025.

Where is Jean Kim located?

Jean Kim practices at 4201 Saint Antoine St, Detroit, MI 48201. The listed phone number is (313) 745-3000.

What is Jean 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 Jean Kim enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jean Kim was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.