Individual provider Active NPI

James Chong Kang

  • Physician Assistant
  • New York, NY
National Provider Identifier
1093226862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021346-1 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 590-3300
NPI assigned
Oct 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00452100 NJ
Physician Assistant 363A00000X 021346-1 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

41 Brownstone Way Apt 207
Englewood, NJ 07631-1211
Phone (310) 404-7900

Other practice location 1

41 Brownstone Way Apt 207
Englewood, NJ 07631-1211
Phone (310) 404-7900

Other practice location 2

150 Washington Ave
Fort Lee, NJ 07024-7826
Phone (310) 404-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190604001499 NJ Practitioner - Physician Assistant 0749513919 Reassigns benefits to 2 organizations
I20200928002830 NY Practitioner - Physician Assistant 0749513919 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

3556 Broadway
New York, NY 10031-3202
Phone (212) 271-4364

356 W 125TH St
New York, NY 10027-4820
Phone (646) 647-1267

617 W 181St St
New York, NY 10033-4937
Phone (646) 346-7922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
021346NYMDSpeech-Language Pathologist
021346-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Sep 26, 2022 Accepting new patients
Friendly Urgent Care, LLC CurrentSince Apr 14, 2019 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Sep 26, 2022 Accepting new patients

Locations

1428 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 591-1350

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: james.kang.1@2983.direct.athenahealth.com
  • Direct secure messaging: jkang1593369@nychhc.direct-ci.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093226862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BROWNSTONE WAY APT 207",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311211",
            "telephone_number": "310-404-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-590-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Brownstone Way Apt 207",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076311211",
            "country_code": "US",
            "telephone_number": "310-404-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lee",
            "state": "NJ",
            "postal_code": "070247826",
            "country_code": "US",
            "telephone_number": "310-404-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "JAMES",
        "middle_name": "CHONG",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00452100",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021346-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.