Richard Kangah, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A55122 Issued in CA

Practice address

3606 Highland Ave 108
Highland, CA 92346-2608

Phone

(909) 864-1006

Fax

(909) 864-1625

NPI assigned

Jun 4, 2006

Last updated

Jan 27, 2017By 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 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15368/brand/1/csg/1/fhir/r4
• Direct secure messaging: richard.kangah.1@15368.direct.athenahealth.com

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.

• Ultimate Medical Practice a Professional Corporation

  • Primary Care Clinic/Center
  • Highland, CA
  • NPI 1962659573
  Medicare reassignment NPD Authorized official
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1255379681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 HIGHLAND AVE 108",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462608",
            "telephone_number": "909-864-1006",
            "fax_number": "909-864-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 HIGHLAND AVE 108",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462608",
            "telephone_number": "909-864-1006",
            "fax_number": "909-864-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANGAH",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A55122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A551220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark C Johnsen, DDS
• Allyson B Johnson, RDN
• Shelby Noel Kaenel
• Nisha Kamboh
• Richard Jerome Kamiyama, O.D.
• Claire Kayitesi
• Corrie Keener, LMFT
• Martin Khairullah
• Jin Rian Kim, MD
• Judy Kim, B.S

• Surgery Physician in Highland, CA
• Providers in Highland, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.