GINNA J KIM (CRNA) – Certified Registered Nurse Anesthetist, NPI 1053649590

GINNA J KIM (CRNA) is a healthcare provider. based in Libertyville, Illinois. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. 041329165 (IL). The NPI Number for GINNA J KIM (CRNA) is 1053649590

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
GINNA J KIM (CRNA)
NPI
1053649590
Phone
(847) 362-2905
Address
801 S MILWAUKEE AVE
Enumeration Date
20 November 2009
Last Update Date
3 January 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8473622900
Graduation Year
2009 (17 years ago)
PAC ID
5092856245
Group Practice PAC ID
6204737596
Professional Enrollment ID
I20100109000189
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:16State licenses:2Digital endpointsOther names

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Provider Addresses for GINNA J KIM (CRNA)

  • Condell Memorial Hospital, 801, South Milwaukee Avenue, Libertyville, Lake County, Illinois, 60048, United States

    LIBERTYVILLE, IL 600483204

    Phone: (847) 362-2905

    Type: Location

  • 105, Willow Parkway, The Woodlands at Fiore, Buffalo Grove, Lake County, Illinois, 60089, United States

    BUFFALO GROVE, IL 600896608

    Phone: (847) 567-3123

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $127.

Total Amount is formed as General ($127) + Research ($0) + Ownership ($0) = $127.

Last reported payment date: 2024-04-18 • Largest payer in this snapshot: Heron Therapeutics, Inc. ($101).

Total Amount

$127

General + Research + Ownership

Payments

2

Total payment records

General Amount

$127

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-18

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2010-01-09

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
I20100109000189ICertified Registered Nurse Anesthetist (Crna)ILTBD

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 60048)

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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: 6204737596View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YIL
-IL
Certified Registered Nurse Anesthetist (Crna)IL
-IL
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YIL
-IL
A N E S T H E S I O L O G YIL
Anesthesiology, Interventional Pain Management, Pain ManagementIL
-MI

Reviews

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Frequently asked questions

What unique ID ties claims to GINNA J KIM (CRNA)?
NPI 1053649590 is assigned to GINNA J KIM (CRNA) under the national enumeration system.
Is GINNA J KIM (CRNA) active in the national directory?
GINNA J KIM (CRNA)'s public NPI profile is in an active state.
What field does GINNA J KIM (CRNA) work in?
You can think of GINNA J KIM (CRNA) as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Does GINNA J KIM (CRNA) practice in Illinois?
You will see Libertyville, Illinois on file for GINNA J KIM (CRNA) alongside any extra practice locations.
How can I contact GINNA J KIM (CRNA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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