Individual provider Active NPI

Steven Kim, PA-C

  • Physician Assistant
  • Pearland, TX
National Provider Identifier
1659040574
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13961 Issued in TX
Practice address
12234 Shadow Creek Pkwy Ste 104
Pearland, TX 77584-7330
Phone
(713) 429-5325
NPI assigned
Sep 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13961 TX Primary

Addresses

Primary practice location

12234 Shadow Creek Pkwy Ste 104
Pearland, TX 77584-7330

Mailing address

7703 Floyd Curl Dr
San Antonio, TX 78229-3901

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
I20211201002557 TX Practitioner - Physician Assistant 0042600215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical School at San Antonio, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Behavioral Health PLLCGroup PAC ID 3971890948, 46 clinicians

Practice addresses (Care Compare)

106 Whispering Pines Ave
Suite 103
Friendswood, TX 77546-6211
Phone (713) 429-5325

12234 Shadow Creek Pkwy
Pearland, TX 77584-7330
Phone (713) 429-5325

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Psychiatry Institute, LLC CurrentSince Mar 31, 2024 Accepting new patients
Kairos Medical LLC Past Accepting new patients

Locations

12234 Shadow Creek Pkwy
Bldg 4
Pearland, TX 77584
Phone (281) 668-8822

12234 Shadow Creek Pkwy
Ste 104
Pearland, TX 77584
Phone (281) 315-9508

Organizations & group practices 3

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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1659040574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12234 SHADOW CREEK PKWY STE 104",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847330",
            "telephone_number": "713-429-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEVEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.