Amanda Y Kim, PT is a medicare enrolled "Physical Therapist" provider in Gluckstadt, Mississippi. Her current practice location is
464 Church Rd Ste 400, Gluckstadt, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 707-5943.
Amanda Y Kim is licensed to practice in Mississippi (license number PT7761) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1205633609.
Healthcare Provider's Profile
| Full Name | Amanda Y Kim |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 464 Church Rd Ste 400, Gluckstadt, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205633609
- Provider Enumeration Date: 02/25/2025
- Last Update Date: 02/25/2025
Medicare PECOS Information:
- PECOS PAC ID: 4082136312
- Enrollment ID: I20250317001852
Medical Identifiers
Medical identifiers for Amanda Y Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205633609 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | PT7761 (Mississippi) | Primary |
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. Amanda Y Kim allows following entities to bill medicare on her behalf.
| Provider Name | Performance Therapy Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1851427132
PECOS PAC ID: 7012971047
Enrollment ID: O20041118000549 |
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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. Amanda Y 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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Amanda Y Kim, PT
921 W Beacon St,
Philadelphia, MS 39350-3229
Ph: (601) 650-0002 | Amanda Y Kim, PT
464 Church Rd Ste 400,
Gluckstadt, MS 39110-6940
Ph: (601) 707-5943 |
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