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MS. JAE MIN KIM APRN, PMHNP-C
NPI 1982428777
Nurse Practitioner - Psychiatric/Mental Health in Stamford, CT

Active since November 08, 2024PECOS EnrolledAccepts Medicare Assignment
1055 SUMMER ST STE 2, STAMFORD, CT 06905(203) 504-9758(203) 547-4914 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 5, 2026, Jun 2, 2026, Nov 8, 2024 (3 updates tracked since 2024).

About Ms. Jae Min Kim Aprn, Pmhnp-c NPPES

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

MS. JAE MIN KIM APRN, PMHNP-C (NPI 1982428777) is an individual psychiatric/mental health provider in Stamford, Connecticut, licensed in Connecticut (12.017259) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Stamford, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1982428777
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMS. JAE MIN KIMCredential: APRN, PMHNP-C
Location Address1055 SUMMER ST STE 2Stamford, CT 06905-5527
Mailing Address1055 Summer St Ste 2Stamford, CT 06905-5527 · (203) 504-9758 · Fax (203) 547-4914
Phone(203) 504-9758
Fax(203) 547-4914
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 8, 2024
Last NPPES UpdateAugust 5, 20263 updates tracked since enumeration
NPPES CertifiedAugust 5, 2026
✔ NPI 1982428777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CT · 12.017259
1055 SUMMER ST STE 2, Stamford, CT 06905
Open in Google Maps ↗

Secondary Practice Location 1

Location 137 Highline TrlStamford, CT 06902-1002 · Phone (347) 581-5447

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Jae Min Kim Aprn, Pmhnp-c 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 ID9436620507
PECOS Enrollment IDI20260609003591
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.

Medicare Billing Reassignment

Medicare enrollment records show Jae Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Evolve Brain Health LLC
Same address
Psychiatry
1055 SUMMER ST
Stamford, CT 06905
  • Reassigned Medicare billing, Connecticut enrollment
  • 6 clinicians in this Medicare group
NPI 1740916105 (203) 504-9758

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06905 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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 5

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

KRISTOFER GENERALES NP
Nurse Practitioner (Psychiatric/Mental Health)
1055 SUMMER ST STE 2
STAMFORD, CT 06905
Western Connecticut Planning Region (914) 413-2324
THOMAS JOSEPH KNIGHTLY JR. M.D.
Psychiatry & Neurology (Psychiatry)
1055 SUMMER ST STE 2
STAMFORD, CT 06905
Western Connecticut Planning Region (203) 504-9758
SHEILAH NOYA PHMNP
Nurse Practitioner (Psychiatric/Mental Health)
1055 SUMMER ST STE 2
STAMFORD, CT 06905
Western Connecticut Planning Region (120) 350-4975
NICHOLAS JOSEPH STANZIONE APRN
Nurse Practitioner (Psychiatric/Mental Health)
1055 SUMMER ST STE 2
STAMFORD, CT 06905
Western Connecticut Planning Region (203) 439-5050
RENEE CAROLINE FONTAINE DNP, FNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1055 SUMMER ST STE 2
STAMFORD, CT 06905
Western Connecticut Planning Region (203) 504-9758

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 1982428777. It was assigned to this individual provider in the NPPES registry on November 8, 2024.

Where is Jae Kim located?

Jae Kim practices at 1055 Summer St Ste 2, Stamford, CT 06905. The listed phone number is (203) 504-9758.

What is Jae Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jae Kim enrolled in Medicare?

Yes. Jae Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jae Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jae Kim reassigns Medicare benefits to Evolve Brain Health LLC (Stamford, CT). 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 Jae 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 Jae Kim was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.