DR. SI-ON KIM (OD) – Optometrist, NPI 1477161875

DR. SI-ON KIM (OD) is a healthcare provider. based in Mckinney, Texas. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 10006 (TX). The NPI Number for DR. SI-ON KIM (OD) is 1477161875

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. SI-ON KIM (OD)
NPI
1477161875
Phone
(972) 548-2015
Address
2600 W UNIVERSITY DR STE 100
Enumeration Date
21 July 2020
Last Update Date
9 May 2024

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
9725482015
Graduation Year
2020 (6 years ago)
PAC ID
0244630937
Group Practice PAC ID
4880787951
Professional Enrollment ID
I20210617001343
Address ID
TX750344199FR8380XPKWY308
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

3,128 OPTOMETRY in TX

Provider Addresses for DR. SI-ON KIM (OD)

  • 2600 W UNIVERSITY DR STE 100

    MCKINNEY, TX 750713209

    Phone: (972) 548-2015

    Type: Mailing

  • 8380 WARREN PKWY STE 101

    FRISCO, TX 750344199

    Phone: (972) 548-2015

    Type: Location

  • 1004 HARBOR CLUB CIR W APT 201

    MEMPHIS, TN 381035813

    Phone: (214) 562-5663

    Type: Mailing

  • 1689 NONCONNAH BLVD STE 120

    MEMPHIS, TN 381322111

    Phone: (901) 523-8990

    Type: Location

  • 2600 W University Dr Ste 100

    McKinney, TX 750713209

    Phone: (972) 548-2015

    Type: Location

  • 1602 SABINE DR

    MIDLOTHIAN, TX 760653823

    Phone: (214) 562-5663

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 52 Open Payments records for all available years, with a total value of $1,430.

Total Amount is formed as General ($1,430) + Research ($0) + Ownership ($0) = $1,430.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: BIOTISSUE HOLDINGS INC. ($478).

Total Amount

$1,430

General + Research + Ownership

Payments

52

Total payment records

General Amount

$1,430

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

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: 2021-06-17

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
I20210617001343IOptometryTXTBD

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
92012Established patient problem focused exam of visual system7333$0
92014Established patient complete exam of visual system4242$0
92004New patient complete exam of visual system3838$0
92134Imaging of retina2423$0
92083Exam of visual field with extended testing1916$0
View full utilization report →

Insurance plans in this area (ZIP 75071)

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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: 4880787951View full group profile
NameSpecialtyState
O P H T H A L M O L O G YTX
O P H T H A L M O L O G YTX
O P T O M E T R YTX
O P T O M E T R YTX

Reviews

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Frequently asked questions

Can I use this page to confirm DR. SI-ON KIM (OD)'s NPI?
Yes. DR. SI-ON KIM (OD) is listed with NPI 1477161875 in the public NPI dataset.
Can I rely on DR. SI-ON KIM (OD) being an active provider?
As of the registry snapshot, DR. SI-ON KIM (OD) is marked active.
What taxonomy line describes DR. SI-ON KIM (OD)?
For research purposes, treat DR. SI-ON KIM (OD) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What area does DR. SI-ON KIM (OD) serve?
DR. SI-ON KIM (OD)'s listing highlights Mckinney, Texas; more addresses can appear in NPPES.
How many locations tie to this NPI?
6 practice locations appear in the available data.

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