Soyoung Kim

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP029814 Issued in PA

Practice address

1626 Locust St
Philadelphia, PA 19103-6305

Phone

(267) 978-4290

NPI assigned

Jun 28, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lenape Valley FoundationGroup PAC ID 7719960913, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lenape Valley Foundation

  • Psychiatry Physician
  • Doylestown, PA
  • NPI 1780735407

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Lenape Valley Foundation

  • Psychiatry Physician
  • Doylestown, PA
  • NPI 1265656623
  NPD
• Lenape Valley Foundation

  • Psychiatry Physician
  • Bristol, PA
  • NPI 1669696472
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1063257178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CROPWELL LN",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189662585",
            "telephone_number": "267-978-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036305",
            "telephone_number": "267-978-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOYOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP029814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seonwoo Kim
• So Yeon Kim, DO
• Soo Yoon Kim, MD
• Soonju Kim, D.M.D.
• Soryoung Rosa Kim, PSY.D.
• Spencer Eliot Kim
• Steve Kim, M.D.
• Su Kyung Kim, CRNP
• Su Young Kim, MD
• Sue Hyon Kim

• Psychiatric/Mental Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.