DR. NATHAN SUNG IN KIM (MD) – Family Medicine Physician, NPI 1558823922

DR. NATHAN SUNG IN KIM (MD) is a healthcare provider. based in Daytona beach, Florida. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. ME148046 (FL). The NPI Number for DR. NATHAN SUNG IN KIM (MD) is 1558823922

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. NATHAN SUNG IN KIM (MD)
NPI
1558823922
Phone
Not provided
Address
201 N CLYDE MORRIS BLVD STE 200
Enumeration Date
3 April 2019
Last Update Date
7 August 2024

Doctor Profile

Medical School Name
WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3867740016
Graduation Year
2019 (7 years ago)
PAC ID
8820327844
Group Practice PAC ID
1456483098
Professional Enrollment ID
I20220813000194
Address ID
FL327207817DE1590XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

6,723 FAMILY PRACTICE in FL

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Provider Addresses for DR. NATHAN SUNG IN KIM (MD)

  • North Clyde Morris Boulevard, Daytona Beach, Volusia County, Florida, 32117, United States

    DAYTONA BEACH, FL 321142765

    Phone:

    Type: Mailing

  • 1590 S STATE ROAD 15A STE 100

    DELAND, FL 327207817

    Phone: (386) 774-0016

    Fax: (386) 774-0606

    Type: Location

  • 309 PALM COAST PKWY NE

    PALM COAST, FL 321373886

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $1,256.

Total Amount is formed as General ($1,256) + Research ($0) + Ownership ($0) = $1,256.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Amgen Inc. ($239).

Total Amount

$1,256

General + Research + Ownership

Payments

27

Total payment records

General Amount

$1,256

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-08-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220813000194IFamily PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32114)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456483098View full group profile
NameSpecialtyState
Internal Medicine, Sports MedicineFL
Physician AssistantFL
Physician AssistantFL
Nurse PractitionerFL
Internal MedicineOK
Physician AssistantFL
Family PracticeFL
Nurse PractitionerFL
Family PracticeFL
Nurse PractitionerKY

Reviews

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Frequently asked questions

Can I use this page to confirm DR. NATHAN SUNG IN KIM (MD)'s NPI?
Yes. DR. NATHAN SUNG IN KIM (MD) is listed with NPI 1558823922 in the public NPI dataset.
Is DR. NATHAN SUNG IN KIM (MD) still practicing?
DR. NATHAN SUNG IN KIM (MD) is currently listed as active in the public NPI registry.
What taxonomy line describes DR. NATHAN SUNG IN KIM (MD)?
For research purposes, treat DR. NATHAN SUNG IN KIM (MD) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. NATHAN SUNG IN KIM (MD)?
DR. NATHAN SUNG IN KIM (MD)'s geographic hint is Daytona Beach, Florida in our summary view.
Why does DR. NATHAN SUNG IN KIM (MD) have multiple addresses?
6 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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