SEONG KIM (MPA) – Medical Physician Assistant, NPI 1023569621

Medical Physician Assistant

SEONG KIM (MPA) is a healthcare provider. based in Belfast, Maine. specializing in Medical Physician Assistant. They hold the professional credentials MPA. They hold a License No. 0110005471 (VA). The NPI Number for SEONG KIM (MPA) is 1023569621

Main info

Female

10 Years Of Experience

Accepts Medicare Assignment

Name

SEONG KIM (MPA)

NPI

1023569621

Phone

(804) 269-8291

Address

PO BOX 28503

Enumeration Date

18 October 2016

Last Update Date

18 July 2024

Doctor Profile

Medical School Name

EASTERN VIRGINIA MEDICAL SCHOOL

Secondary Phone

8042698291

Graduation Year

2016 (10 years ago)

PAC ID

8426339078

Group Practice PAC ID

6709026040

Professional Enrollment ID

I20161220000870

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience42

Completeness75

Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for SEONG KIM (MPA)

PO BOX 28503
BELFAST, ME 049152037
Phone: (804) 269-8291
Fax: (804) 269-8293
Type: Mailing
2010, Pemberton Road, Tuckahoe, Henrico County, Virginia, 23238, United States
HENRICO, VA 23238
Phone: (804) 301-4342
Type: Mailing
Parham Surgery Center, 7650, East Parham Road, Laurel, Henrico County, Virginia, 23228, United States
SUITE 220
HENRICO, VA 232944373
Phone: (804) 269-8291
Type: Location
5000 MONUMENT AVE FL 2
RICHMOND, VA 232303627
Phone: (804) 269-8291
Fax: (804) 269-8293
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-12-20

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

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20161220000870	I	Physician Assistant	VA	TBD

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 04915)

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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: 6709026040View full group profile