NPIMap

Individual provider Active NPI

Jennifer S Kang, MD

  • Neurological Surgery Physician
  • Traverse City, MI
National Provider Identifier
1144376815
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301506782 Issued in MI
Practice address
1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone
(231) 392-0640
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 43942 CO
Neurological Surgery Physician 207T00000X 4301506782 MI Primary

Addresses

Primary practice location

1221 Sixth St Ste 300
Traverse City, MI 49684-2360

Mailing address

1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone (231) 392-0640

Other practice location 1

4545 E 9th Ave
Ste. 300
Denver, CO 80220-3901
Phone (303) 333-8740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090116000502 CO Practitioner - Neurosurgery 8426111485 Reassigns benefits to 1 organization
I20230720003020 SD Practitioner - Neurosurgery 8426111485 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Indiana University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgery of South Dakota PCGroup PAC ID 5698195030, 67 clinicians

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

677 Cathedral Dr
Suite 310
Rapid City, SD 57701-6018
Phone (605) 755-6720

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion71
Laminectomy or laminotomy (partial removal of spine bones)20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43942COMDNeurological Surgery Physician
4301506782MIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Jun 22, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 20, 2016 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Acute Care Surgery of South Dakota PC CurrentSince Dec 19, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Jun 22, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 20, 2016 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

677 Cathedral Dr
Ste 310
Rapid City, SD 57701
Phone (605) 755-6720

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Interoperability endpoints

  • Direct secure messaging: jkang.134139@regionalhealth.sdhealthlink.net

Organizations & group practices 6

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1144376815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842360",
            "telephone_number": "231-392-0640",
            "fax_number": "303-333-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842360",
            "telephone_number": "231-392-0640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4545 E 9th Ave",
            "address_2": "Ste. 300",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802203901",
            "country_code": "US",
            "telephone_number": "303-333-8740",
            "fax_number": "303-333-3314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "43942",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301506782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.