Individual provider Active NPI

Hyojin Kim, PA-C

  • Surgical Physician Assistant
  • Kingwood, TX
National Provider Identifier
1336966142
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA18778 Issued in TX
Practice address
22999 Highway 59 N Ste 200
Kingwood, TX 77339-4439
Phone
(832) 995-4330
Fax
(832) 995-4331
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA18778 TX Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

22999 Highway 59 N Ste 200
Kingwood, TX 77339-4439

Mailing address

6115 Abbotts Bridge Rd Apt 603
Johns Creek, GA 30097-5754
Phone (678) 677-2442

Other practice location 1

6115 Abbotts Bridge Rd Apt 603
Johns Creek, GA 30097-5754
Phone (678) 677-2442

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
I20250315000181 TX Practitioner - Physician Assistant 9335661610 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: hyojin.kim@hca9.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1336966142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 ABBOTTS BRIDGE RD APT 603",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300975754",
            "telephone_number": "678-677-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22999 HIGHWAY 59 N STE 200",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394439",
            "telephone_number": "832-995-4330",
            "fax_number": "832-995-4331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6115 Abbotts Bridge Rd Apt 603",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300975754",
            "country_code": "US",
            "telephone_number": "678-677-2442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYOJIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA18778",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.