Individual provider Active NPI

Ho Henry Kang, M.D.

  • Specialist
  • Madera, CA
National Provider Identifier
1356349260
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A46410 Issued in CA
Practice address
816 W Yosemite Ave
Suite 102
Madera, CA 93637-4587
Phone
(559) 674-7054
Fax
(559) 674-4080
NPI assigned
Jul 13, 2005
Last updated
Oct 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A46410 CA Primary

Addresses

Primary practice location

816 W Yosemite Ave
Suite 102
Madera, CA 93637-4587

Mailing address

816 W Yosemite Ave
Suite 102
Madera, CA 93637-4587
Phone (559) 674-7054

Other identifiers 2

IdentifierTypeStateIssuer
00A464101MedicaidCA
A46410OtherCASTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101217000689 CA Practitioner - Physical Medicine and Rehabilitation 3375731334 Practice locations: Madera, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A46410CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno Community Hospital and Medical Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1356349260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W YOSEMITE AVE",
            "address_2": "SUITE 102",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936374587",
            "telephone_number": "559-674-7054",
            "fax_number": "559-674-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W YOSEMITE AVE",
            "address_2": "SUITE 102",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936374587",
            "telephone_number": "559-674-7054",
            "fax_number": "559-674-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "HO",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A46410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A464101",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A46410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.