JAE HUN KIM (PA) – Physician Assistant, NPI 1063055481

JAE HUN KIM (PA) is a healthcare provider. based in Las vegas, Nevada. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA2230 (NV). The NPI Number for JAE HUN KIM (PA) is 1063055481

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JAE HUN KIM (PA)
NPI
1063055481
Phone
(702) 877-5199
Address
PO BOX 35380
Enumeration Date
18 October 2019
Last Update Date
8 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7025793253
Graduation Year
2019 (7 years ago)
PAC ID
8123454691
Group Practice PAC ID
4981687779
Professional Enrollment ID
I20200130003153
Address ID
NV891021535LA4750XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

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Provider Addresses for JAE HUN KIM (PA)

  • McCarran International Airport, 5757, Wayne Newton Boulevard, Enterprise, Clark County, Nevada, 89154, United States

    LAS VEGAS, NV 891335380

    Phone: (702) 877-5199

    Type: Mailing

  • 540, North Nellis Boulevard, Sunrise Manor, Las Vegas, Clark County, Nevada, 89110, United States

    LAS VEGAS, NV 891105368

    Phone: (702) 877-5199

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $252.

Total Amount is formed as General ($252) + Research ($0) + Ownership ($0) = $252.

Last reported payment date: 2024-02-27 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($130).

Total Amount

$252

General + Research + Ownership

Payments

3

Total payment records

General Amount

$252

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-27

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: 2020-01-30

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
I20200130003153IPhysician AssistantNVTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes4137$0
View full utilization report →

Insurance plans in this area (ZIP 89133)

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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: 4981687779View full group profile
NameSpecialtyState
Family PracticeTX
Internal MedicineNV
Physician AssistantNV
-KY
Nurse PractitionerNV
-NV
Nurse PractitionerNV
O B S T E T R I C S/ G Y N E C O L O G YNV
Nurse PractitionerIL
-NV

Reviews

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Frequently asked questions

Is there an official ID for JAE HUN KIM (PA) in U.S. healthcare records?
The official identifier for JAE HUN KIM (PA) is NPI 1063055481.
Is there an active status for JAE HUN KIM (PA)?
For scheduling context, JAE HUN KIM (PA) is shown as active in the registry.
What kind of doctor is JAE HUN KIM (PA)?
JAE HUN KIM (PA) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with JAE HUN KIM (PA)?
Directory geography for JAE HUN KIM (PA) centers on Las Vegas, Nevada.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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