Soo Yeon Kelly Kang, M.D,

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A109239 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 860W
Santa Monica, CA 90404-2189

Phone

(310) 301-7396

NPI assigned

Mar 31, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Soo Yeon Kang Former name

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

Psychiatry

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of California Los AngelesGroup PAC ID 4587857727, 84 clinicians

Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Contra Costa Regional Medical Center Hospital, Martinez, CA, CCN 050276

Merit-based Incentive Payment System (MIPS)

Final score

87.46 of 100Reported as group

Quality

80.82

Promoting interoperability

100

Improvement activities

40

Cost

71.93

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkang21955@direct.uclahealth.org

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.

• Contra Costa County

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment Care Compare group NPD
• Regents of the University of California Los Angeles

  • Neurology Physician
  • Los Angeles, CA
  • NPI 1609194497
  Medicare reassignment Care Compare group NPD
• Special Service for Groups, Inc.

  • Voluntary or Charitable Agency
  • Los Angeles, CA
  • NPI 1952442949
  Medicare reassignment NPD
• UC Regents

  • Adult Development & Aging Psychologist
  • Los Angeles, CA
  • NPI 1750368999

  Psychiatry

  Medicare reassignment NPD
• Contra Costa County

  • Adult Mental Health Clinic/Center
  • Pittsburg, CA
  • NPI 1073691598
  NPD
• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD
• Special Service for Groups, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1669503793
  NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  Care Compare affiliation

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1508038415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 860W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042189",
            "telephone_number": "310-301-7396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11303 W Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900666003",
            "country_code": "US",
            "telephone_number": "310-301-7396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "SOO YEON",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A109239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508038415",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOO YEON",
            "last_name": "KANG",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Won Kang, MD,MPH
• Dong Su Kang, LAC
• Jeanney Kang
• Mina Rim Kang, MD
• Patty Kang, PHARMD
• Stephen John Kania, M.D.
• Laura Merlyn Kanofsky, LCSW
• Valerie Kanter, DMD
• Ishita Kanungo
• Kao Plastic Surgery Medical Corporation

• Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.