Individual provider Active NPI

Kenny Keui-Hsiang Huang, DPM

  • Foot & Ankle Surgery Podiatrist
  • West Covina, CA
National Provider Identifier
1417253147
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4929 Issued in CA
Practice address
855 N Lark Ellen Ave
Suite C
West Covina, CA 91791-1099
Phone
(626) 869-8769
Fax
(949) 579-2069
NPI assigned
Jan 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4929 CA Primary

Addresses

Primary practice location

855 N Lark Ellen Ave
Suite C
West Covina, CA 91791-1099

Mailing address

1 League Unit 61200
Irvine, CA 92602-7054
Phone (626) 869-8769

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
I20150126001200 CA Practitioner - Podiatry 9436473345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

855 N Lark Ellen Ave
West Covina, CA 91791-1099
Phone (626) 869-8769

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue622
Removal or shaving of skin growth84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4929CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Opd Foot and Ankle CurrentSince Dec 9, 2014 Accepting new patients
Paradise Valley Hospital Past Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients
Chinatown Service Center Past Accepting new patients

Locations

1 League
Unit 61200
Irvine, CA 92602

855 N Lark Ellen Ave
Ste C
West Covina, CA 91791
Phone (626) 339-5437

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kenny.huang.p1@direct.cscla.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1417253147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LEAGUE UNIT 61200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926027054",
            "telephone_number": "626-869-8769",
            "fax_number": "949-579-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N LARK ELLEN AVE",
            "address_2": "SUITE C",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911099",
            "telephone_number": "626-869-8769",
            "fax_number": "949-579-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "KENNY",
        "middle_name": "KEUI-HSIANG",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-27",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.