Individual provider Active NPI

Justin Y Kang, L.AC

  • Acupuncturist
  • Newark, NJ
National Provider Identifier
1114286028
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00089800 Issued in NJ
Practice address
266 Van Buren St
Newark, NJ 07105-2514
Phone
(201) 621-3439
NPI assigned
May 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00089800 NJ Primary

Addresses

Primary practice location

266 Van Buren St
Newark, NJ 07105-2514

Mailing address

240 Broad Ave
Palisades Park, NJ 07650-1509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MZ00089800NJMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Oncare Acupuncture & Herb, PC Acupuncturist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1114286028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 VAN BUREN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071052514",
            "telephone_number": "201-621-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "JUSTIN",
        "middle_name": "Y",
        "name_prefix": "Mr.",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00089800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.