Individual provider Active NPI

David B Huang, M.D.

  • Specialist
  • Osage Beach, MO
National Provider Identifier
1063418879
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
109950 Issued in MO
Practice address
985 Executive Drive
Osage Beach, MO 65065
Phone
(573) 348-4863
Fax
(573) 348-4863
NPI assigned
Jun 27, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 109950 MO Primary

Addresses

Primary practice location

985 Executive Drive
Osage Beach, MO 65065

Mailing address

985 Executive Dr
Osage Beach, MO 65065-3496
Phone (573) 348-4863

Other identifiers 2

IdentifierTypeStateIssuer
204838908MedicaidMO
128576OtherBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050810000039 MO Practitioner - Plastic and Reconstructive Surgery 3779512710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Medical College of Wisconsin, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

985 Executive Dr
Osage Beach, MO 65065-3496

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy34
Melanoma (skin cancer) excision85
Removal of tissue1-10
Removal of skin lesions12
Skin biopsy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109950MOMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Osage Valley Plastic Surgery PC Specialist CurrentSince Jun 1, 2012 Accepting new patients

Locations

985 Executive Dr
Osage Beach, MO 65065
Phone (573) 348-4863

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063418879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 EXECUTIVE DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653496",
            "telephone_number": "573-348-4863",
            "fax_number": "573-348-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 EXECUTIVE DRIVE",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "65065",
            "telephone_number": "573-348-4863",
            "fax_number": "573-348-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "109950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204838908",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "128576",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.