Individual provider Active NPI

Stefan Sungsoo Kim, M.D.

  • Neurological Surgery Physician
  • Minneapolis, MN
National Provider Identifier
1952500191
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
67643 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 273-8383
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 67643 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

720 Washington Ave SE
Minneapolis, MN 55414-2924
Phone (612) 884-0649

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
I20200717000663 MN Practitioner - Neurosurgery 0345331435 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

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

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion87
Laminectomy or laminotomy (partial removal of spine bones)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67643MNMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Bethesda Hospital CurrentSince Jul 1, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 1, 2020 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jul 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2020 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Mar 7, 2025 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 1, 2020 Accepting new patients
Healtheast Care System CurrentSince Jul 1, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jul 1, 2020 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2020 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Mar 7, 2025 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 1, 2020 Accepting new patients

Locations

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

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

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

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

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

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

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

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

720 Washington Ave SE
Ste 200
Minneapolis, MN 55414
Phone (612) 730-1345

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

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

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

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

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

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

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

Interoperability endpoints

  • Direct secure messaging: skim505341@fairview.direct-ci.com

Organizations & group practices 23

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 23

Hospital & facility affiliations 3

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1952500191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142924",
            "telephone_number": "612-884-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-273-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEFAN",
        "middle_name": "SUNGSOO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "67643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.