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ANDREW H KIM M.D.
NPI 1972857159
Pediatrics - Pediatric Critical Care Medicine in Minneapolis, MN

Active since November 09, 2012PECOS EnrolledAccepts Medicare Assignment
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-6000 Get Directions Write a Review

NPPES record last updated: June 16, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Andrew H Kim M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW H KIM M.D. (NPI 1972857159) is an individual pediatric critical care medicine provider in Minneapolis, Minnesota, licensed in California (A120214) and active in the NPI registry since November 2012. He is enrolled in Medicare PECOS, maintains a secondary practice location in Madera, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1972857159
Entity TypeIndividualMale
Primary Taxonomy2080P0203X
Provider Legal NameANDREW H KIMCredential: M.D.
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing AddressPo Box 7096Stockton, CA 95267-0096 · (209) 956-7725 · Fax (209) 956-7733
Phone(612) 273-6000
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateNovember 9, 2012
Last NPPES UpdateJune 16, 2023
NPPES CertifiedJune 16, 2023
✔ NPI 1972857159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in CA · A120214
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Secondary Practice Location 1

Location 19300 Valley Childrens PlMadera, CA 93636-8761 · Phone (559) 353-3000 · Fax (858) 279-8415

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrew H Kim M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345569935
PECOS Enrollment IDI20230627000581
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Andrew Kim reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE, OUTREACH LAB DEPARTMENT
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1316008212 (612) 273-7838
Pediatric Anesthesia Associates Medical Group Inc
1,489 mi
Anesthesiology
9300 VALLEY CHILDRENS PL
Madera, CA 93636
  • Reassigned Medicare billing, California enrollment
  • 55 clinicians in this Medicare group
NPI 1558588871 (559) 353-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Kim's NPI number?

The NPI number for Andrew Kim is 1972857159. It was assigned to this individual provider in the NPPES registry on November 9, 2012.

Where is Andrew Kim located?

Andrew Kim practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 273-6000.

What is Andrew Kim's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Andrew Kim enrolled in Medicare?

Yes. Andrew Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Andrew Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Kim reassigns Medicare benefits to 2 organizations: Fairview Health Services (Minneapolis, MN) and Pediatric Anesthesia Associates Medical Group Inc (Madera, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andrew Kim was last updated on June 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.