JEFFREY JISUNG KIM (PT DPT) – Physical Therapist, NPI 1073197984

JEFFREY JISUNG KIM (PT DPT) is a healthcare provider. based in Bryan, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT DPT. They hold a License No. 1345176 (TX). The NPI Number for JEFFREY JISUNG KIM (PT DPT) is 1073197984

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY JISUNG KIM (PT DPT)
NPI
1073197984
Phone
(979) 774-9958
Address
3700 CROSS PARK DR
Enumeration Date
6 May 2021
Last Update Date
7 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9797749958
Graduation Year
2020 (6 years ago)
PAC ID
3173926250
Group Practice PAC ID
6507831773
Professional Enrollment ID
I20210727002672
Address ID
TX778024137BR3700XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

5,355 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for JEFFREY JISUNG KIM (PT DPT)

  • 3700 CROSS PARK DR

    BRYAN, TX 778024137

    Phone: (979) 774-9958

    Fax: (979) 774-9978

    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: 2021-07-27

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
I20210727002672IPhysical Therapist In Private PracticeTXTBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes3,346211$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes1,460182$0
97140Therapy procedure using manual technique, each 15 minutes1,154127$0
97113Therapy procedure using water pool to exercises, each 15 minutes1,11767$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care858137$0
View full utilization report →

Insurance plans in this area (ZIP 77802)

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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: 6507831773View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
-TX

Reviews

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Frequently asked questions

Where can patients find JEFFREY JISUNG KIM (PT DPT)'s NPI?
You can confirm JEFFREY JISUNG KIM (PT DPT) with NPI 1073197984; it appears in the national provider directory.
Is JEFFREY JISUNG KIM (PT DPT)'s NPI currently valid?
The extract we use shows JEFFREY JISUNG KIM (PT DPT) as active.
What kind of provider is JEFFREY JISUNG KIM (PT DPT)?
The page reflects Physical Therapist for JEFFREY JISUNG KIM (PT DPT). Clinical services aligned with this taxonomy classification.
What location metadata exists for JEFFREY JISUNG KIM (PT DPT)?
The page summarizes Bryan, Texas for JEFFREY JISUNG KIM (PT DPT); expand the address list for detail.
Is JEFFREY JISUNG KIM (PT DPT) a real provider?
This page reflects official NPPES data for NPI 1073197984. Always confirm identity and privileges with the practice and licensing boards.

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