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

Samuel Kim, OD

Individual provider Optometrist · NPI 1174257703

Samuel Kim, OD is an Optometry in Philadelphia, Pennsylvania. Graduated from Pennsylvania College of Optometry in 2022, 4 years ago. Practices with The Elder Eye Care Group, Inc, a 12-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
4
Trained at
Pennsylvania College of Optometry
Licensed in
PA
In the registry since
2022
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone: (215) 276-6000
Fax: (215) 276-6096
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OEG003897 (PA)

Record details

NPI number1174257703
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 11, 2022
Last updated in NPPESJuly 11, 2022
Certification dateJuly 11, 2022

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolPENNSYLVANIA COLLEGE OF OPTOMETRY
Graduated 2022 (4 years in practice)
Group practice The Elder Eye Care Group, Inc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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