Individual provider Active NPI

Charles X Kim, MD

  • Cardiovascular Disease Physician
  • Minneapolis, MN
National Provider Identifier
1639181746
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
48936 Issued in MN
Practice address
720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone
(612) 884-0649
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 102446 MN
Cardiovascular Disease Physician 207RC0000X 48936 MN Primary

Addresses

Primary practice location

720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414

Mailing address

720 Washington Ave SE
University of Minnesota Physicians
Minneapolis, MN 55414
Phone (612) 884-0649

Other identifiers 1

IdentifierTypeStateIssuer
894683000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060906000199 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2163426164 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Chicago, Pritzker School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians

Practice addresses (Care Compare)

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

6405 France Ave S
Suite W200
Edina, MN 55435-2163
Phone (952) 848-5600

Hospital & facility affiliations

  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince May 16, 2011 Accepting new patients
Healtheast Care System CurrentSince Apr 4, 2020 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 16, 2015 Accepting new patients
Fairview Clinics CurrentSince May 16, 2011 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Apr 4, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Bethesda Hospital CurrentSince Apr 4, 2020 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Mar 1, 2020 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Apr 4, 2020 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 16, 2015 Accepting new patients
Healtheast Medical Research Institute Cardiovascular Disease CurrentSince Mar 1, 2020 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care Cardiovascular Disease Past Accepting new patients

Locations

14101 Fairview Dr
Ste 140
Burnsville, MN 55337

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6405 France Ave S
Ste 200
Edina, MN 55435
Phone (612) 626-7681

6525 France Ave S
Ste 275
Edina, MN 55435
Phone (952) 831-8346

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

6405 France Ave S
Ste W200
Minneapolis, MN 55435
Phone (952) 836-3700

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: ckim205928@fairview.direct-ci.com

Organizations & group practices 20

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 20

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1639181746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-884-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-884-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHARLES",
        "middle_name": "X",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "102446",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "48936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894683000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.