Deactivated NPI 1679787055 Deactivated / Inactive NPI Male Practitioner

Dr. Charles Chang Hee Kim , MD

Ophthalmology • Saint Paul, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Charles Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 09, 2007

NPI Deactivation Date January 16, 2025

Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Charles Kim, MD was a registered Ophthalmology practicing in Saint Paul, MN. Throughout an active medical career spanning 18 years, Dr. Kim provided care at the practice location at 401 PHALEN BLVD # MS 41102E until profile deactivation on 2025-01-16.

Historical Medicare Part B clinical services included new patient outpatient office visit, photography of content of eyes, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

401 Phalen Blvd # Ms 41102e
Healthpartners Specialty Center 401

Saint Paul, MN 551305302

Telephone 6512547500

Fax 6512547557

Associated Practice Facility / Clinic

🏢 Group Health Plan Inc Facility NPI 1932147683

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Saint Paul, MN

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 17.0 Yrs

State Avg: 24.4 Yrs

Regional Practice Density

17 Specialists

Practicing in Saint Paul, MN (457 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	116	116	$174.27	$107.07
92285 Photography of content of eyes	106	106	$36.03	$20.02
99213 Established patient office or other outpatient visit, typically 15 minutes	89	82	$141.75	$87.68
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	82	82	$260.50	$159.71
92083 Exam of visual field with extended testing	59	59	$98.65	$59.82
68840 Probing of nasal-tear duct	38	36	$302.15	$181.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	33	$199.96	$123.41
15823 Removal of excessive skin and fat of upper eyelid	29	29	$1258.36	$766.13
67950 Enlargement of eyelid margin	23	23	$983.81	$606.48
67950 Enlargement of eyelid margin	17	17	$988.57	$556.51
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	15	12	$1036.38	$468.32
67908 Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis	14	14	$998.92	$549.40
67904 Repair of tendon of upper eyelid	13	12	$1285.25	$790.43
67914 Suture repair of a turning-outward defect of upper or lower eyelid	13	13	$870.24	$268.49
67900 Repair of brow paralysis	12	12	$1077.85	$391.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	144	144	$261.63	$162.62
92285 Photography of content of eyes	138	135	$35.97	$20.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	105	105	$175.92	$109.86
99213 Established patient office or other outpatient visit, typically 15 minutes	91	75	$141.76	$88.56
92083 Exam of visual field with extended testing	81	80	$97.94	$60.38
15823 Removal of excessive skin and fat of upper eyelid	48	48	$1293.43	$808.80
68840 Probing of nasal-tear duct	48	46	$311.00	$193.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	40	$200.49	$125.35
67950 Enlargement of eyelid margin	23	22	$985.45	$565.87
67908 Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis	22	22	$1006.01	$615.26
67914 Suture repair of a turning-outward defect of upper or lower eyelid	18	17	$709.18	$221.17
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	16	13	$225.81	$119.25
67950 Enlargement of eyelid margin	13	13	$953.26	$594.58
67810 Biopsy of eyelid	12	12	$290.91	$181.85
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	11	11	$1044.22	$592.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92285 Photography of content of eyes	55	55	$47.07	$19.17
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$335.45	$164.41
92083 Exam of visual field with extended testing	37	37	$98.14	$61.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	34	34	$219.59	$110.06
99213 Established patient office or other outpatient visit, typically 15 minutes	28	28	$265.41	$90.36
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	26	18	$542.00	$121.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	23	$352.18	$127.41
15823 Removal of excessive skin and fat of upper eyelid	14	14	$4190.44	$831.19
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	14	14	$73.00	$23.56
92082 Exam of visual field with intermediate testing	12	12	$190.00	$47.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	36	34	$281.00	$89.92
92082 Exam of visual field with intermediate testing	33	33	$186.39	$47.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$523.00	$166.63
92285 Photography of content of eyes	30	30	$87.00	$19.28
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$342.00	$106.43
15823 Removal of excessive skin and fat of upper eyelid	16	16	$4382.00	$828.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	16	$346.00	$129.64
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	16	12	$560.00	$129.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	16	16	$266.00	$91.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$326.00	$100.61
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$327.00	$109.97
92082 Exam of visual field with intermediate testing	11	11	$177.00	$48.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	74	70	$253.00	$89.32
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$311.00	$107.20
15823 Removal of excessive skin and fat of upper eyelid	37	37	$3830.03	$818.30
92082 Exam of visual field with intermediate testing	27	27	$171.00	$46.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	25	$310.00	$105.98
92285 Photography of content of eyes	24	24	$73.00	$17.28
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	23	13	$482.00	$108.67
67950 Enlargement of eyelid margin	12	12	$2920.50	$640.74
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$292.00	$98.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	47	44	$228.00	$85.17
92082 Exam of visual field with intermediate testing	30	30	$148.00	$47.97
92285 Photography of content of eyes	30	30	$90.00	$16.56
15823 Removal of excessive skin and fat of upper eyelid	19	19	$3873.32	$784.29
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	16	$304.00	$106.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$303.00	$105.26
67950 Enlargement of eyelid margin	12	12	$3283.33	$593.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92012 Established patient problem focused exam of visual system	70	61	$221.00	$84.31
92082 Exam of visual field with intermediate testing	29	29	$132.00	$48.55
92285 Photography of content of eyes	27	27	$86.00	$17.16
15823 Removal of excessive skin and fat of upper eyelid	24	24	$3763.92	$797.22
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$300.00	$105.25
67950 Enlargement of eyelid margin	16	15	$2382.50	$594.14
11440 Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less	15	12	$418.00	$119.71
92002 New patient problem focused exam of visual system	15	15	$211.00	$81.29
67908 Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis	14	14	$3176.36	$374.41
68840 Probing of nasal-tear duct	14	12	$671.00	$162.93

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License CA A80043

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners

Dr. Jerry Kobrin , MD

Ophthalmology

NPI 1023084084

Doctor of Medicine (M.D.)

Dr. Matthew Hendricks , OD

Optometrist

NPI 1104391325

Doctor of Optometry

Dr. Spencer Cleland , MD

Ophthalmology

NPI 1235767286

Doctor of Medicine (M.D.)

Dr. Matthew Cossack , MD

Ophthalmology

NPI 1275948275

Doctor of Medicine (M.D.)

Dr. Katherine Montealegre , OD

Optometrist - Corneal and Contact Management

NPI 1295097277

Doctor of Optometry

Dr. Matthew Bauer , OD

Optometrist

NPI 1316177348

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

⚠️

NPI Profile Deactivated January 16, 2025

Record deactivated on January 16, 2025

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 16, 2021

Ophthalmology (License #56188 in MN)

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Updated Practice Location November 01, 2019

Registered at 401 PHALEN BLVD, SAINT PAUL, MN 551305302 (Tel: 6512547500)

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NPI Profile Active May 01, 2013

NPI status registered as active in NPPES database

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Updated Practice Location May 01, 2013

Registered at 401 PHALEN BLVD # MS 41102E, HEALTHPARTNERS SPECIALTY CENTER 401, SAINT PAUL, MN 551305302 (Tel: 6512547500)

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Updated Business Mailing Address May 01, 2013

Registered at 8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 554254516 (Tel: 9095582154)

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Provider Name / Credentials Updated May 01, 2013

Recorded as CHARLES KIM, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2013

Ophthalmology (License #A80043 in CA)

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Initial NPI Registration & Enumeration May 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1679787055

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 09, 2007

Last Update: May 01, 2013

Deactivation Date: January 16, 2025

Update or Correct Profile

Mailing Address

8170 33rd Ave S, Ms21110q

Minneapolis, MN 554254516

Phone: 9095582154

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.