Sujin Kim, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA66127 Issued in CA

Practice address

911 Hampshire Rd Ste 1
Westlake Village, CA 91361-2833

Phone

(805) 885-0801

Fax

(805) 885-0802

NPI assigned

Nov 27, 2019

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 NY, NJ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Metro Dermatology of NJ,PA

  • Procedural Dermatology Physician
  • Fort Lee, NJ
  • NPI 1437353372
  Medicare reassignment
• Metro Dermatology of Ny,PC

  • Physician Assistant
  • Flushing, NY
  • NPI 1336343268
  Medicare reassignment

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1295371003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 HAMPSHIRE RD STE 1",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612833",
            "telephone_number": "805-885-0801",
            "fax_number": "805-885-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 HAMPSHIRE RD STE 1",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612833",
            "telephone_number": "805-885-0801",
            "fax_number": "805-885-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUJIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA66127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Kwangkyum Kim, L.AC
• Eleanor Kim, PH.D.
• Eun Sang Sang Kim
• Jiyoung Kim
• Kap Ryong Kim, D.C., LA.C
• Thomas Jinkyu Kim, MD
• Kimberly Yudt, Licensed Clinical Social Worker Corp.
• Debra L King, MA
• Kinney Physical Therapy & Wellness,P.C.
• Daniel Kinney, PT

• Surgical Physician Assistant in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.