Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Melanie Kim, PAC

Individual provider Physician Assistant · NPI 1063594224

Melanie Kim, PAC is a Physician Assistant in Cumming, Georgia. Qualified in 2003, 23 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia and New York.

Years since qualifying
23
Licensed in
GA, NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

1505 Northside Blvd Ste 2400
Cumming, GA 30041-7662
Phone: (770) 292-3490
Fax: (770) 292-9016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10453 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 009284 (NY)

Record details

NPI number1063594224
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 19, 2006
Last updated in NPPESDecember 27, 2022
Certification dateDecember 27, 2022
Mailing address1505 Northside Blvd Ste 2400, Cumming, GA 30041-7662

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Cumming