Individual provider Active NPI

Kyongdeuk Kang, M.D.

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1316206329
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
17342 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-0111
NPI assigned
May 10, 2012
Last updated
May 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17342 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

437 SE 8TH St
Gainesville, FL 32601-6927
Phone (404) 513-6489

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702001045 TX Practitioner - Emergency Medicine 2567697089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of South Florida College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.43 of 100Reported as group
Quality
93.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17342FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

6800 Scenic Dr
#1550
Rowlett, TX 75088
Phone (972) 412-2273

Organizations & group practices 1

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.

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1316206329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 SE 8TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326016927",
            "telephone_number": "404-513-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "KYONGDEUK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "17342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.