Taeuk Kang, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15157 Issued in TX

Practice address

580 S Denton Tap Rd
Coppell, TX 75019-4098

Phone

(972) 462-0762

NPI assigned

Nov 10, 2020

Last updated

Feb 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD (past)
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1174125595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "ORANGE GROVE",
            "state": "TX",
            "postal_code": "783722070",
            "telephone_number": "361-382-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 S DENTON TAP RD",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194098",
            "telephone_number": "972-462-0762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 N Giraud",
            "address_purpose": "LOCATION",
            "city": "Cotulla",
            "state": "TX",
            "postal_code": "780143113",
            "country_code": "US",
            "telephone_number": "830-879-2279",
            "fax_number": "830-879-2235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "TAEUK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-10",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA15157",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktaeuk2471111@direct.texashealth.org",
            "affiliation": "N",
            "endpointDescription": "health information exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "580 S Denton Tap Rd",
            "city": "Coppell",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750194098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• JT4 Senior Care LLC (Home Instead Senior Care)
• Ariel Jun, DC
• Kairos Chiropractic PLLC
• Gail Diana Kaiser, PT
• Brian J Kallarackal, DDS
• Kamna Kapil, MD
• Neha Katoch, PT,DPT
• Anchal Kaur
• Farhana Kazi, MD
• Jason Eric Kessler

• Physician Assistant in Coppell, TX
• Providers in Coppell, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.