Matthew Joshua King-Lung Kor, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A180770 Issued in CA

Practice address

702 Mountain Ranch Rd
San Andreas, CA 95249

Phone

(092) 754-4564

Fax

(209) 942-3462

NPI assigned

Apr 11, 2019

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Lakeside Home Medical ServicesGroup PAC ID 1850338054, 19 clinicians

Sutter Bay HospitalsGroup PAC ID 3476506528, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, Lakeport, CA, CCN 057620
• Adventist Health Home Care Services Home health agency, Lower Lake, CA, CCN 057710
• Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329
• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkor704853@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819

  Single Specialty

  Medicare reassignment NPD
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Summit Campus

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD

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

• Adventist Health Clearlake Hospital Inc.

  dba Adventist Health Clear Lake

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • Critical Access Hospital
  • Lakeport, CA
  • NPI 1952634008
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  dba Sutter Care at Home

  • Home Health Agency
  • Lakeport, CA
  • NPI 1871734244
  Care Compare affiliation
• Western Health Resources

  dba Adventist Health Home Care Services

  • Home Health Agency
  • Lower Lake, CA
  • NPI 1063762896
  Care Compare affiliation

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1508329947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 MOUNTAIN RANCH RD",
            "address_2": "C/O MEDICAL STAFF OFFICE",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "092-754-4564",
            "fax_number": "209-942-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOR",
        "first_name": "MATTHEW",
        "middle_name": "JOSHUA KING-LUNG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A180770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Jan Khan
• Michael Dennis Kifune, MD
• Lee Kimball
• Regina Elizabeth King, SLP
• Marin Koorkoff, MFTI
• Kathryn Krayk, RN
• Sara Toni Lashley, C.M.T., L.L.C.C.
• Daysi Lorena Lawton, PSY.D.
• Lauren Rae Liberty, LCSW
• Jesse Steven Limas, MFT

• Family Medicine Physician in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.