Jacquelyn Kang, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

217113 Issued in MA

Practice address

421 N Main St
Leeds, MA 01053-9764

Phone

(413) 584-4040

NPI assigned

Sep 13, 2005

Sex

Female

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

Other names 1

• Jacquelyn Reilly Kang Former name

Medicare fee-for-service enrollment

Enrolled in MA

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

Merit-based Incentive Payment System (MIPS)

Final score

81.45 of 100Reported as group

Quality

69.96

Promoting interoperability

79

Improvement activities

40

Cost

77.58

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ear, Nose & Throat Surgeons of Western New England, LLC

  • Otolaryngology Physician
  • Springfield, MA
  • NPI 1386685881
  Medicare reassignment

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1033104328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JACQUELYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "217113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018675",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "KANG",
            "middle_name": "REILLY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James R Jewell, MD
• Michael Edward Johnson, O.D.
• Jennifer Noel Joyce, PSY. D.
• Carmen C Junno, LICSW
• Christine E Kandrotas, COTA
• Ahmad Karagah, M.D.
• Gary Kaskey, M.D.
• Elizabeth Kelley
• Grace Ann Kelley, LCSW
• James Patrick Kerr, D.P.M.

• Otolaryngology Physician in Leeds, MA
• Providers in Leeds, MA by specialty
• Otolaryngology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.