Bobby Kipak Kong, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

BK057809 Issued in MI

Practice address

5325 Elliott Dr
Suite # 102
Ypsilanti, MI 48197-8633

Phone

(734) 712-5500

Fax

(734) 712-8209

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bkong2@direct.mhc.net
• Direct secure messaging: mhc.cardiothoracicsurgeons.tc@mhc.midirect.net

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.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1124425285
  NPD
• Munson Medical Center

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1508390741
  NPD
• Michigan Multispecialty Physicians, P.C.

  • Critical Care Medicine (Internal Medicine) Physician
  • Ypsilanti, MI
  • NPI 1912941337

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1013943083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE # 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-5500",
            "fax_number": "734-712-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "address_2": "SUITE # 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-5500",
            "fax_number": "734-712-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "BOBBY",
        "middle_name": "KIPAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "BK057809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4826911",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MHC.CardiothoracicSurgeons.TC@mhc.midirect.net",
            "affiliation": "N",
            "address_1": "1221 Sixth St Ste 202",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexander Kokesh, OTRL
• Julia C Kolder
• Carol Kolesar, NP
• Sara Kolesar, MS, BCBA, LBA
• Frederick C Kominars, P.A.-C
• Elizabeth Konheim, CRNA
• Jeremy Konheim
• Kimberly Jeanne Koning-Randall, CRNA
• Jennifer Kononowech, LMSW
• Ava Konrad

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.