Individual provider Active NPI

Brandon S Kang, LCSW

  • Clinical Social Worker
  • Kailua Kona, HI
National Provider Identifier
1114302866
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4048 Issued in HI
Practice address
75-5751 Kuakini Hwy Ste 101a
Kailua Kona, HI 96740-1705
Phone
(808) 326-5629
NPI assigned
Jul 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4048 HI Primary

Addresses

Primary practice location

75-5751 Kuakini Hwy Ste 101a
Kailua Kona, HI 96740-1705

Mailing address

75-5751 Kuakini Hwy Ste 203
Kailua Kona, HI 96740-1753
Phone (808) 326-5629

Other identifiers 1

IdentifierTypeStateIssuer
797061MedicaidHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818004990 HI Practitioner - Clinical Social Worker 7810202942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Hawaii Community Health Center IncGroup PAC ID 1557389400, 63 clinicians

Practice addresses (Care Compare)

75-5751 Kuakini Hwy
Suite 203
Kailua Kona, HI 96740

75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1752

81 -980 Halekii St
Kealakekua, HI 96750-8177

95-5583 Mamalahoa Hwy
Naalehu, HI 96772
Phone (808) 333-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
West Hawaii Community Health Center, Inc. CurrentSince Aug 10, 2015 Accepting new patients
West Hawaii Community Health Center, Inc. CurrentSince Aug 10, 2015 Accepting new patients

Locations

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

75-5751 Kuakini Hwy
Ste 203
Kailua Kona, HI 96740
Phone (808) 326-3878

Networks

  • HI PPO

Organizations & group practices 2

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": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1114302866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-326-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 101A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401705",
            "telephone_number": "808-326-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "BRANDON",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "797061",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

Verify at the official NPI Registry.