NPIMap

Individual provider Active NPI

Samuel Young Kim, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Katy, TX
National Provider Identifier
1467984690
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
S8057 Issued in TX
Practice address
23331 Grand Reserve Dr
Katy, TX 77494-4850
Phone
(281) 560-3321
Fax
(281) 505-3895
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X S8057 TX Primary

Addresses

Primary practice location

23331 Grand Reserve Dr
Katy, TX 77494-4850

Mailing address

PO Box 400
Katy, TX 77492-0400
Phone (281) 560-3321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611001563 TX Practitioner - Physical Medicine and Rehabilitation 7618377664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Texas Medical School at Houston, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23331 Grand Reserve Dr
Katy, TX 77494-4850
Phone (281) 505-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S8057TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
B&SK Holdings PLLC Physical Medicine & Rehabilitation CurrentSince Jul 1, 2021 Accepting new patients
Encompass Health Rehabilitation Hospital of Katy, LLC Past Accepting new patients

Locations

18500 Katy Fwy
Houston, TX 77094
Phone (281) 206-9020

23331 Grand Reserve Dr
Katy, TX 77494
Phone (281) 505-3500

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1467984690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774920400",
            "telephone_number": "281-560-3321",
            "fax_number": "281-505-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23331 GRAND RESERVE DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774944850",
            "telephone_number": "281-560-3321",
            "fax_number": "281-505-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SAMUEL",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2023-11-27",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "S8057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.