Individual provider Active NPI

Jina Kim, M.D.

  • Surgery Physician
  • Falls Church, VA
National Provider Identifier
1194081117
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101270485 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3300
Phone
(703) 638-8438
NPI assigned
Apr 3, 2012
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101270485 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3300

Mailing address

3300 Gallows Rd
Falls Church, VA 22042-3300
Phone (703) 638-8438

Other practice location 1

44055 Riverside Pkwy Ste 108
Leesburg, VA 20176-5179
Phone (703) 858-8600

Other practice location 2

8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone (571) 472-4724

Other practice location 3

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201230002006 DC Practitioner - General Surgery 8224360102 Reassigns benefits to 2 organizations
I20211110000279 VA Practitioner - General Surgery 8224360102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Michigan Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44055 Riverside Pkwy
Suite 108
Leesburg, VA 20176-5179
Phone (703) 858-8600

8081 Innovation Park Dr
Fairfax, VA 22031-4867

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101270485VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Oct 5, 2020 Accepting new patients

Locations

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

8081 Innovation Park Dr
Ste 301
Fairfax, VA 22031
Phone (571) 472-6431

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

44055 Riverside Pkwy
Ste 108
Leesburg, VA 20176
Phone (703) 858-8600

Interoperability endpoints

  • Direct secure messaging: jkim741805@soc.inova.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1194081117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423300",
            "telephone_number": "703-638-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423300",
            "telephone_number": "703-638-8438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44055 Riverside Pkwy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765179",
            "country_code": "US",
            "telephone_number": "703-858-8600",
            "fax_number": "703-858-8603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8081 Innovation Park Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314867",
            "country_code": "US",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-0241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-8600",
            "fax_number": "703-858-8603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101270485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.