Individual provider Active NPI

Jay Kahng, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1477752038
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A67454 Issued in CA
Practice address
1301 20TH St Ste 110
Santa Monica, CA 90404-2096
Phone
(310) 453-0419
Fax
(310) 829-1960
NPI assigned
Jul 13, 2007
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A67454 CA Primary

Addresses

Primary practice location

1301 20TH St Ste 110
Santa Monica, CA 90404-2096

Mailing address

1301 20TH St Ste 110
Santa Monica, CA 90404-2096
Phone (310) 453-0419

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkahng586007@oc.providencedirect.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040316001335 CA Practitioner - Internal Medicine 7315837101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1301 20TH St
Suite 110
Santa Monica, CA 90404-2096
Phone (310) 453-0419

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Bethesda Medical Center Past Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

1301 20th St
Ste 110
Santa Monica, CA 90404
Phone (310) 453-0419

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jkahng586007@oc.providencedirect.org

Organizations & group practices 2

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 4

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1477752038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 110",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042096",
            "telephone_number": "310-453-0419",
            "fax_number": "310-829-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 110",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042096",
            "telephone_number": "310-453-0419",
            "fax_number": "310-829-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHNG",
        "first_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A67454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkahng586007@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1301 20th St Ste 110",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.