Su Gym Kim, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Providence, Rhode Island. He graduated from medical school in 2004 and has 20 years of diverse experience with area of expertise as Physical Medicine And Rehabilitation. He is a member of the group practice Select Physical Therapy Of Connecticut Limited Partnership, Trinity Health Of New England Provider Network Organization Inc and his current practice location is
593 Eddy St, George Building, First Floor, Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at
(401) 444-3777.
Su Gym Kim is licensed to practice in Rhode Island (license number MD15614) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1235418369.
Physician's Profile
| Full Name | Su Gym Kim |
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| Gender | Male |
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| Speciality | Physical Medicine And Rehabilitation |
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| Experience | 20 Years |
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| Location | 593 Eddy St, Providence, Rhode Island |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Su Gym Kim graduated from medical school in 2004
NPI Data:
- NPI Number: 1235418369
- Provider Enumeration Date: 08/07/2011
- Last Update Date: 10/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 5395969943
- Enrollment ID: I20190207002162
Medical Identifiers
Medical identifiers for Su Gym Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1235418369 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 46722 (Kentucky) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | MD15614 (Rhode Island) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Select Physical Therapy Of Connecticut Limited Partnership | 9638080625 | 13 |
| Trinity Health Of New England Provider Network Organization Inc | 0941113567 | 635 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Su Gym Kim allows following entities to bill medicare on his behalf.
| Entity Name | Trinity Health Of New England Provider Network Organization Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003882812
PECOS PAC ID: 0941113567
Enrollment ID: O20031110000651 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Su Gym Kim is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Su Gym Kim, MD
117 Ellenfield St, Suite 101,
Providence, RI 02905-4513
Ph: (401) 444-6779 | Su Gym Kim, MD
593 Eddy St, George Building, First Floor,
Providence, RI 02903-4923
Ph: (401) 444-3777 |
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