ALICE J KIM (LICSW) – Clinical Social Worker, NPI 1184632663

ALICE J KIM (LICSW) is a healthcare provider. based in Medford, Massachusetts. specializing in Clinical Social Worker. They hold the professional credentials LICSW. They hold a License No. 111412 (MA). The NPI Number for ALICE J KIM (LICSW) is 1184632663

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
ALICE J KIM (LICSW)
NPI
1184632663
Phone
(781) 338-7270
Address
101 MAIN ST
Enumeration Date
3 August 2006
Last Update Date
10 April 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6174968700
Graduation Year
2000 (26 years ago)
PAC ID
9133123532
Group Practice PAC ID
2062303894
Professional Enrollment ID
I20060825000398
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for ALICE J KIM (LICSW)

  • 101, Main Street, Medford, Middlesex County, Massachusetts, 02155, United States

    SUITE 112

    MEDFORD, MA 021554540

    Phone: (781) 338-7270

    Fax: (781) 396-5086

    Mailing address matches the actual address.

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: 2006-08-25

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
I20060825000398IClinical Social WorkerMATBD

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 02155)

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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: 2062303894View full group profile
NameSpecialtyState
-MA
-MA
-MA
D E R M A T O L O G YMA
Nurse PractitionerMA
Internal MedicineMA
Nurse PractitionerNH
Emergency MedicineMA
O P T O M E T R YMA
Nurse PractitionerRI

Reviews

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Frequently asked questions

How is ALICE J KIM (LICSW) identified in CMS data?
CMS-hosted NPPES data lists ALICE J KIM (LICSW) with NPI 1184632663.
Can I rely on ALICE J KIM (LICSW) being an active provider?
As of the registry snapshot, ALICE J KIM (LICSW) is marked active.
What is ALICE J KIM (LICSW) best known for clinically?
Directory data describes ALICE J KIM (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does ALICE J KIM (LICSW) list a practice location?
Patients near Medford, Massachusetts may find ALICE J KIM (LICSW) in results; validate coverage separately.
Is the information about ALICE J KIM (LICSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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