Individual provider Active NPI

Soo-Hyun Lee-Kim, F.N.P.

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1174617856
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
667181 Issued in TX
Practice address
6411 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-7878
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 667181 TX Primary

Addresses

Primary practice location

6411 Fannin St
Houston, TX 77030-1501

Mailing address

P O Box 201088
Houston, TX 77216-1088
Phone (713) 500-3500

Other identifiers 3

IdentifierTypeStateIssuer
8Y0667OtherTXBCBSTX
183699101MedicaidTX
183699102OtherTXCSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20070209000568 TX Practitioner - Nurse Practitioner 8123020773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

2130 W Holcombe Blvd
Univ of TX M D Ande Life Sciences Plaza
Houston, TX 77030-4009
Phone (713) 592-5433

Hospital & facility affiliations

  • University of Texas M D Anderson Cancer Center Hospital, Houston, TX, CCN 450076

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
667181TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Nov 16, 2008 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

Interoperability endpoints

  • Direct secure messaging: sleekim13539@utmdandersoncc.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238716800000",
    "number": "1174617856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 201088",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772161088",
            "telephone_number": "713-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-KIM",
        "first_name": "SOO-HYUN",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "667181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8Y0667",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183699101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "183699102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.