Heejin Kim, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

36472 Issued in TX

Practice address

411 N Washington Ave
Suite 5000
Dallas, TX 75246-1713

Phone

(214) 820-9315

NPI assigned

Jun 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Star Psychology and Consulting, PLLCGroup PAC ID 7012302466, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Blue Star Psychology & Consulting, PLLC

  • Rehabilitation Psychologist
  • Plano, TX
  • NPI 1679162564
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1609004472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE",
            "address_2": "SUITE 5000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461713",
            "telephone_number": "214-820-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE",
            "address_2": "SUITE 5000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461713",
            "telephone_number": "214-820-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEEJIN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "36472",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36472",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "TX",
            "license": "36472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flora Sewon Kim, MD
• Hamin Kim
• Hanna Kim, M.S., BCBA
• Harry KW Kim, MD
• Hee Jung Kim, DMD
• Heekyung Kim, OT/L
• Heidi Kim, M.D.
• Ho Jin Kim, M.D.
• Hyoshin Kim
• Ian Hyun Kim

• Clinical Neuropsychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.