SUEANN KIM – Addiction Psychiatry Physician, NPI 1568752111

SUEANN KIM is a healthcare provider. based in Belmont, Massachusetts. specializing in PSYCHIATRY. They hold a License No. 265630 (MA). The NPI Number for SUEANN KIM is 1568752111

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
SUEANN KIM
NPI
1568752111
Phone
(617) 855-2000
Address
115 MILL ST
Enumeration Date
17 April 2011
Last Update Date
11 February 2022

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7076244000
Graduation Year
2011 (15 years ago)
PAC ID
3476778234
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20180625001769
Address ID
CA956889494VA1XXXXDRXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:15State licenses:1Other namesUpdated within 12 months

1,743 PSYCHIATRY in MA

Provider Addresses for SUEANN KIM

  • 115 MILL ST

    BELMONT, MA 024781064

    Phone: (617) 855-2000

    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: 2018-06-25

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
I20180625001769IPsychiatryCATBD

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 02478)

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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: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

Is SUEANN KIM listed with a National Provider Identifier?
Yes — SUEANN KIM has NPI 1568752111 on file in the registry.
Is SUEANN KIM shown as active in public data?
Registry records indicate SUEANN KIM maintains an active NPI.
What clinical focus is listed for SUEANN KIM?
At a glance, SUEANN KIM is tied to Addiction Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is SUEANN KIM associated with Belmont?
Public fields place SUEANN KIM around Belmont, Massachusetts. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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