Individual provider Active NPI

Hyun K Kang, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Garden Grove, CA
National Provider Identifier
1184046195
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5101 Issued in CA
Practice address
12828 Harbor Blvd
Suite 320
Garden Grove, CA 92844-5834
Phone
(714) 636-3032
Fax
(714) 636-3116
NPI assigned
Jan 9, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3633 FL
Foot & Ankle Surgery Podiatrist 213ES0103X E5101 CA Primary

Addresses

Primary practice location

12828 Harbor Blvd
Suite 320
Garden Grove, CA 92844-5834

Mailing address

12828 Harbor Blvd
Suite 320
Garden Grove, CA 92840-5834
Phone (714) 636-3032

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140506002006 CA Practitioner - Podiatry 7618100215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Foot and Ankle Medical CenterGroup PAC ID 6507180973, 2 clinicians

Practice addresses (Care Compare)

5451 La Palma Ave
Suite 26
La Palma, CA 90623-1730
Phone (714) 735-8588

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue19
Removal of skin lesions1-10
Removal of nail tissue1280
Removal or shaving of skin growth1068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5101CAMDFoot & Ankle Surgery Podiatrist
PO3633FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Foot and Ankle Medical Center Foot & Ankle Surgery CurrentSince Jan 1, 2015 Accepting new patients
Southern California Foot and Ankle Medical Center Foot & Ankle Surgery CurrentSince Jan 1, 2015 Accepting new patients
Vascular Interventional Group, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Michael D. Kotzen, Inc. Foot & Ankle Surgery PastSince Sep 13, 2020 Accepting new patients

Locations

6601 Rugby Ave
Ste 100
Huntington Park, CA 90255
Phone (323) 749-9770

5451 La Palma Ave
Ste 26
La Palma, CA 90623
Phone (562) 606-4519

520 S Virgil Ave
Ste 105
Los Angeles, CA 90020
Phone (213) 352-1090

18375 Ventura Blvd
Tarzana, CA 91356
Phone (818) 422-5322

3400 Lomita Blvd
Ste 305
Torrance, CA 90505
Phone (310) 539-5888

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1184046195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12828 HARBOR BLVD",
            "address_2": "SUITE 320",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405834",
            "telephone_number": "714-636-3032",
            "fax_number": "714-636-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12828 HARBOR BLVD",
            "address_2": "SUITE 320",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928445834",
            "telephone_number": "714-636-3032",
            "fax_number": "714-636-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "HYUN",
        "middle_name": "K",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-09",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3633",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.